Clinical Decision Support Systems Paper and Responses

Here is ONE response post to the faculty that I need with 175 words.

According to the AHRQ (2014) “The CDS Consortium used a four-stage approach to clinical decision support. The first step was to identify, or develop, a guideline to describe a specific clinical best practice. Next, key rules and logical statements were abstracted. This logic was used to develop computer code for CDS rules. And finally, a web service was created to deliver these CDS rules to multiple different EHR systems nationwide.” “The description by Osheroff, et al. of what they call the “five rights” of CDS is a good summary of what is needed for effective delivery: CDS should be designed to provide the right information to the right person in the right format through the right channel at the right time (i.e., when the information is needed). At this point in time, the appropriate decision is not whether to design and implement CDS, but how to design and implement it so that, as the Institute of Medicine report says, we “make it easy to do the right thing”…Clinical decision support (CDS) systems provide clinicians, staff, patients, and other individuals with knowledge and person-specific information, intelligently filtered and presented at appropriate times, to enhance health and health care. The Institute of Medicine has long recognized problems with health care quality in the United States, and for more than a decade has advocated using health information technology (IT), including electronic CDS, to improve quality” (Berner, 2009).

CDS improves patient care by putting EBP and resources at the provider’s fingertips. There is no way a human can remember everything; the system offers reminders and suggestions to providers as well as safety alerts. “For more complex cognitive tasks, such as diagnostic decision making, the aim of CDS is to assist, rather than to replace, the clinician, whereas for other tasks (such as presentation of a predefined order set) the CDS may relieve the clinician of the burden of reconstructing orders for each encounter. The CDS may offer suggestions, but the clinician must filter the information, review the suggestions, and decide whether to take action or what action to take” (Berner, 2009).

Here is the SECOND response post to a classmate I need with 175 words. Kindly respond by Saturday. Thanks!

According to Berner (2009), The Clinical Decision Support Consortiums “provide clinicians, staff, patients, and other individuals with knowledge and person-specific information, intelligently filtered and presented at appropriate times, to enhance health and health care.” It is computerized support for healthcare workers’ decision-making. It can alert a physician of poor drug-to-drug interactions before the order goes through. It may contain formularies to predict each patient’s risk with any treatment. It includes best practice clinical guidelines to guide the healthcare professional’s actions on how to best treat their patient in their unique situations. It helps to make sure treatments and timely follow-ups are not missed. They “assist clinicians in decision-making by taking over some routine tasks, warning clinicians of potential problems, or providing suggestions for clinician consideration.”

We use Epic in my emergency department. As soon as we open the chart, we are confronted with the specific patients’ formulary calculations for drug abuse and the frequency of emergency visits. It tells us how many current narcotic prescriptions the patient has, from how many different providers, and if any overlap. While prescribing or administering medication, it will tell us if there is a risk or poor interaction with any medications the patient is already prescribed, if the patient has an allergy in this medication category, or if there may be a pregnancy or lactation risk. The system calculated sepsis risk from vital signs and lab results and will provide a pop-up for us to review the information that led the system to this conclusion and the order to begin treating the patient. These safety guards help us to make excellent and quick decisions and act fast to improve the patient’s status and avoid harm.