Clinical Decision Support System Analysis

Health care providers as well as nurses must keep track of all pertinent patient information and failure to do so leads to detrimental effect on the patient's life. CIS clinical information systems are "large, computerized database management systems that support several types of activities that include physician order entry, result retrieval, documentation and decision support". CIS is intended to replace medical records department of a hospital or any other medical institution. Physicians and clinicians can safely and quickly access information, order medication and treatments and implement appropriate care. CIS will hopefully improve productivity, increase quality care and reduce costs across the organization.

In the United State, hospitals, less than two-thirds of hospitals have any type of CDS. (Byrne et al., n.d.). We might be wondering why the use of CDC is low among health care provider, based on my study the following are some of the barriers in implantation of CDS: Usability issues (Byrne et al., n.d.). This include rate of the process of information, user what the information that he or she wanted as fasted rate as possible, it graphical User Interface is not as friendly as it should be. Secondary ,the CDS Alarms functionality include lists of possible diagnoses, drug interaction alerts, or preventive care reminders and the overused of theses alarm may lead to the clinician not paying too much attention to them as it would be seen as normal sound (Bolch, 2012).These are some of the way, in which these barrier can be remove, need for better user friendly design , if the interface is well design and easy to use more physician who like to use it in making clinical decision, There is needs for the vendor and researcher to address this design failure ("Clinical Decision Support (CDS) Initiative | AHRQ National Resource Center; Health Information Technology: Best Practices Transforming Quality, Safety, and Efficiency," 2014). It is imperative to customize CDS after it is implemented failure to do this can lead to failure. For example, disabling some of the alarm system that is redundant or lack practical value, and constantly training of clinician to ensure important reminder do receive necessary attention (Bolch,

The task support field has been revolutionized through the implementation of the electronic medical record in conjunction with EPIC. The universalization of the electronic medical record will increase the accessibility of patient information to clinicians as well as increase the amount of data available for clinical use, reducing medical error significantly. However, the greatest tool to increase the standardization of care, reduction of practice pattern variation, successful and effective diagnosis, and correct care path choice will result from the development of Information system facilitating true interdisciplinary care. Clinical Information specialists offer the possibility to improve the quality and reduce the cost of care by influencing medical decisions at the time and place that these decisions are made. Our clinical Nurse Information specialist would alert physicians and Nurses when outlier results are returned from data entry of laboratory testing. The data attained for a specific patient can then be compared to the general population to indicate whether the data is within the normal fit or is an outlier that may require further analysis. Such a practice would induce the physician and Nurses to notice certain data that may otherwise go unnoticed, and therefore, alter the diagnosis of the patient. A physician may enter a possible diagnosis into the system and then receive feedback from

Systems without a knowledge base, on the other hand, rely on machine learning to analyze clinical data. There are pros and cons to implementing clinical decision support systems. The foremost challenge is that a CDSS must be integrated with a healthcare organization 's clinical workflow, which is often already complex. Some clinical decision support systems are standalone products that lack interoperability with reporting and electronic health record (EHR) software. Furthermore, incorporating large amounts of data into existing systems places significant strain on application and infrastructure maintenance. CDSS is "a process for enhancing health-related decisions and actions with clinical knowledge and patient information to improve health and healthcare delivery.

A clinical information system (CIS) collects patient information from technological applications. The information is distributed to certain locations in the facility/healthcare setting. Locations vary based on unit, such as OBGYN, cardiology, ICU, or psychiatric. The CIS represents the patient’s history of illnesses and interactions with health care providers by encoding knowledge capable of helping clinicians decide about the patient’s condition, treatment options, and wellness activities (Sittig et al., 2002).

Wright and Sittig have described the history of clinical decision support by breaking it up into four phases. These four phases are: standalone systems, integrated systems, standards-based systems, and service models (Wright, 2008).

A healthcare organization is working to implement a Clinical Decision Support System (CDSS). The system will support medical clinicians in making

TVGs support system when it comes to their supportive policies and guidelines they have a MSD book with all the residents care plans, if they have fall risks, if they are a one or two assist (that’s when one CNA or two are needed), whether they like showers or a bath. CNAs have a book where they record the input and output of the residents that is in each group that has to be recorded each night before your shift is over. They is a separate book that’s located on each floor with all the policies and procedures in it. There is now a system out that the nursing home I was employed at doesn’t have and need. Its called the Clinical decision support system (CDSS). The CDSS comes with an alert for weaken state, development in condition, constipation,

Clinical decision support system (CDSS) has a potential to enhance health care if used and adopted. The delayed implementation and acceptance of CDSS is due to the poor usability of the system (Nair et al., 2015). Usability testing can highlight barriers of poor usability in a system. Therefore, the aim of this study was to conduct a literature search on the effect of iterative usability testing on improving the usability and favorability scores of the clinical decision system. I searched the literature using PubMed and Google Scholar. Six articles were used for this paper. Five were iterative studies. These articles were reviewed and two variables were measured in this study. The initial usability and favorability scores of the system were

CDSS are often incorporated within EHR systems and integrated with other computer-based functions that offer patient-care summary reports, feedback on quality indicators, and benchmarking2-3. Knowledge management systems providing access to scientific literature and strategies for CVD prevention may also be linked with CDSS1-4. Many studies conducted in different health care settings have documented the effectiveness of CDSS in improving quality of care and clinical outcomes for a variety of conditions such as CVD prevention, cancer screening, immunization, antenatal care, just to mention a few1,5-11. The mission of this paper is to review the roles and the applications of CDSS in the prevention of IHD.

3. The older diagnostic decision support systems (DDSS) failed largely because they were not integrated into the organizational and hospital’s clinical information system (CIS). Also, the electronic health record (EHR) adoption was most likely much lower than today’s adoption rate given the HITECH Act. This rationale was covered in class.1 If the DDSS is not part of the CIS, that meant the DDSS will not be incorporated into the doctor’s workflow. This will most likely interrupt and delay the doctor’s workflow and tempo.1 This would have discouraged the doctor from using the DDSS because it will be perceived as an extra work without a clear benefit. The class lecture also pointed out that the data entry was a manual process, again, interrupting

Based on rules, clinical decision support system (CDSS) may serve poorly in healthcare due to the if—then function. This system takes a diagnosis and spits out appropriate information based on the individual situation that it is analyzing. However, modern medicine can be considered as scientifically grounded, but evidence based practices can maintain a theoretical approach. There is some sort of conflict when trying to combine scientific perspectives with rational theories5. Hence, many errors can occur using the CDSS, such as alert fatigue, shifting of human roles, and currency of the CDS content6. There is a key issues of safety management when considering CDSS. There are certain systems that are better than others; hence great attention

Furthermore, after achieving a computerized system in the documentation of patient information, it is important to stabilize and re-evaluate the change process. It is important the nurse leader, and the super users provide the staff with updates and ongoing education to keep abreast with the changes in the information technology platform. In other words to ensure success, information technology experts must be available at any deemed moment to address any issues resulting from the EMR system. Furthermore, clinical educators should also be availed to provide necessary training to new nurses and staffs. Still, the system must be in regulation to set standards and policies thus in evaluation compliance to set regulations as the HIPAA must be checked and necessary improvement made concerning information and data security.

During the course of my two-year program in the Healthcare Informatics, we have touch on many aspect of the field to get us ready for the work field. We had taken courses from: computer application, data communication, information system analysis to creating organizational values. All of these courses were great, but the one that comes to mind that will be best integrated with my thesis project is decision support system. My key focus for this thesis project is, interoperability equal continuity through standards. As a result, the course decision support system will be a perfect complement.

Having a single view of the patient and their treatment and recovery plan is invaluable in ascertaining which are the most and least effective tactics in treatment. The 360-degree view of the patient and the many processes supporting them is crucial for increasing the accuracy, effectiveness and performance of treatment programs over time (Blakeman, 1985). Computerized management systems are critical for organizing, analyzing and translating the massive amount of data captured on patients, treatment and recovery processes, and the use of supporting IT systems to optimize patient health and organizational provider performance (Peshek, Cubera, Gleespen, 2010). The ability to aggregate and intelligently use all available data, information, patient-based and process-generated data to deliver higher levels of quality care is possible when computerized management systems are used throughout healthcare organizations.