What is clinical decision support (CDS)?
The integration of advanced clinical decision support (CDS) tools is paramount not only for enhancing patient outcomes but also for optimizing operational efficiency. By leveraging real-time data and predictive analytics, CDS systems empower healthcare providers to make informed, evidence-based decisions that are crucial in today’s fast-paced medical environments. Investing in robust CDS can ensuring that clinical practices are proactive in their approach to patient care and also allow providers to practice at the top of their license.
Solution framework
| Point of care solutions |
|---|
| Relevant information display — Ensure that the provider has a composition of up-to-date and necessary patient information and data in the form of direct summaries and insights to help make decision in providing care to the patient. |
| Care recommendations — Prompts providers with next step recommendations based on patient findings, labs, interactions, and results. |
| Documentation, billing, and coding support — Offer guidance, accuracy checks, and analytics to ensure precise documentation and improved billing and coding practices for revenue cycle management. |
| Risk prediction – Forecast the likelihood of adverse events, complications, or safety incidents by identifying patients at elevated risk for adverse outcomes. |
| Medication and dosing support — Inform clinicians about prescribing and medication dose adjustment based on patient-specific data, evidence-based guidelines, or pharmacogenomics. |
| Care pathway and protocol — Ensure that the physician has the latest guidelines and protocols to decide on the next best step in the patient’s care |
| Beyond the point of care solutions |
|---|
| Care management — Support the provider in uncovering and addressing gaps and unmet needs in patient care through screenings and patient history analysis. |
| Workflow support — Plan activity-based actions and the order in which care should occur based on specific events in the patient journey. |
| Disease prediction — Forecast the likelihood of an individual developing specific diseases/conditions through patient history analysis and specific indications from their interactions and assessments. |
| Intelligent diagnostics — Assist healthcare providers in diagnosing and interpreting medical conditions from labs and radiology readings more accurately and efficiently. |
The case for clinical decision support
As healthcare systems face increasing challenges in providing high-quality care, addressing inefficiencies and costs, and tackling the effects of clinician burnout, clinical decision support systems offer promising solutions to address those challenges.
Improve patient care, quality, and safety
The healthcare industry today faces significant challenges in patient care, particularly in areas such as sepsis management and diagnostic accuracy. Sepsis alone accounts for 1 in 3 observed hospital mortalities and leads to $24B in annual costs for healthcare systems (Sepsis Alliance). Additionally, 10-30% of medical errors are related to diagnosis (Healthcare IT). These stark statistics underscore the urgent need for innovative solutions like clinical decision support to enhance patient care and outcomes. These solutions can offer providers up-to-date information to improve practice and patient care quality (EvidenceCare) (PubMed). They also provide evidence-based guidance, personalized treatment plans, and enhanced diagnostic accuracy (Folio3). As such, clinical decision support solutions can increase patient safety by reducing errors and adhering to clinical guidelines (NCBI1), overall reducing variation in care delivery. By leveraging clinical decision support, healthcare providers can make more informed decisions, leading to improved patient outcomes and a higher quality of care.
Address healthcare inefficiencies and cost
Healthcare is currently fraught with significant inefficiencies, with an estimated $750B in annual healthcare spending wasted on unnecessary services and diagnostic errors (PinnacleCare). Clinical decision support can help address these issues by increasing efficiency and compliance through the availability and recommendation of guidelines and regulations (NCBI2). It can also decrease costs by decreasing inpatient length of stay, suggesting cheaper medication alternatives, and reducing test duplication (NCBI1). These solutions also support clinical and diagnostic coding for administrative and revenue cycle management purposes. These improvements can lead to substantial cost savings and more efficient use of healthcare resources, benefiting both providers and patients.
Enhance provider experience and efficacy
Healthcare providers currently face increasing burnout, exacerbated by feelings of inability to provide high-quality care or make preventable errors. Excessive documentation requirements and administrative tasks are also major contributors to burnout (Healthcare IT News). Clinical decision support can help alleviate these issues by reducing cognitive load and streamlining workflows (Zynx Health). It facilitates coordination among multi-disciplinary teams through automated messages and reminders (NCBI3). Additionally, some clinical decision support systems help streamline documentation processes to reduce non-clinical workloads, overall improving the clinical care team experience when they are able to focus on providing care at the top of their license. By addressing these challenges, clinical decision support can improve provider satisfaction, potentially leading to better retention rates and overall healthcare quality.
Key attributes of clinical decision support solutions
Core clinical content
- Content library — Off-the-shelf repository of clinical pathways and order sets
- Evidence-based review — Ongoing, thorough review of the content library against the latest medical literature and evidence
- Customization — Ability to update content to reflect local conditions, e.g. availability of supplies, practice patterns, workflows, clinician preferences
- Continuity content sharing — Ability to draw on existing pathways, order sets, and best practices from other users of the platform
Content development
- Authorship tools — Tools that seamlessly enable the development of new pathways and the customization of existing ones
- Governance tools — Functionality that supports governance and maintenance (e.g. permissions, approvals, updates) of clinical pathways
- Care gap identification — Ability to draw on medical evidence and literature to identify and address gaps in current pathways and other sets
Clinical pathway integration
- EHR Integration — Ability to seamlessly integrate new pathways and updates to existing pathways with EHR workflows and leverage EHR data to inform triggers and alerts
- Analytics & Reporting — Configurable analytics and reporting encompassing a broad range of categories and metrics (e.g. utilization/compliance, cost of care, outcomes)
Organizing for success with clinical decision support
To successfully implement clinical decision support, health systems must begin by defining their guiding principles. It’s crucial to prioritize physician involvement and autonomy while ensuring that the solution aligns with established clinical protocols. By keeping these factors in mind, health systems can effectively tailor their clinical decision support initiatives to meet the needs and preferences of doctors while enhancing patient care.
- Ensure physician involvement and leadership. Physicians are the primary users of clinical decision support solutions and influence the adoption and acceptance in daily practice. Their involvement helps in maintaining the right balance between customization and standardization of systems. Identify physician champions who can advocate for the system and provide valuable insights throughout the implementation process.
- Craft thoughtful messaging to promote adoption across the practice. Develop communication strategies that highlight how clinical decision support supports, rather than replaces, physician expertise. Many physicians worry that CDS will take away their autonomy. Address those concerns by focusing on how CDS can enhance clinical decision making and improve patient outcomes by offering suggestions and alternatives, ultimately leaving physicians with the autonomy to make the final decision.
- Align clinical decision support content with established clinical protocols. Review and ensure that the content provided by your clinical decision support vendor aligns with your organization’s clinical protocols and physician viewpoints. This may involve customizing the system to reflect local practices and preferences.
