Clinical Decision-Support System

Clinical Decision-Support System

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Looking back in time over the last 40 years even computers were huge, bulky, and unsightly. Few homes had them and individuals had no idea what capabilities could arise. After the evolution of the internet, and computers becoming more popular, physicians had been able to use these tools to improve the quality of patient care. However with the recent mandate the government has put on electronic health record systems (HER), one key objective is to optimize the use of Clinical Decision based support systems (CDSS). By utilizing such systems, better care at a cheaper rate can be provided to patients saving both time and money.
Major components of a CDSS

Looking into major components of a CDSS there are two major ones. These include diagnostic support tools, and treatment support tools. Diagnostic support helps physicians make a better diagnosis based on the patient symptoms, medications, and medical records according to Yuan, (2011). Diagnostic errors are means for lawsuits among health care professionals so information needs to be accurate. Helping physicians to avoid common keystroke errors is common ground for dismissing a malpractice lawsuit (Yuan, 2011).
Patient treatment relies on clinicians to stay compliant with treatment guidelines and make the right decisions for patients with known allergies, and underlying medical conditions. Treatment guidelines according to Yuan (2011) include “Avoiding known drug interactions, dispensing the proper medications, and staying on schedule with catheter changes to say the least” (Developer works journal, pp. 6, para. 2).
The second major component of the CDSS aims at workflow and ease-of-use with a computer program. There are many computer programs out there but a common one being implemented into many medical facilities is called “Isabel”. According to computer programmer Matt Hagland (2012), “Isabel takes a natural language patient summary from the physician notes in the EHR, identifies keywords contained in the summary, and then generates a list of related diagnoses from its probabilities database” (Healthcare informatics journal, pp. 4, para. 3). This type of program eliminates improper diagnostics based on what the patient is experiencing as far as symptoms and treatment.
The second component of this system is the ability of programs to identify and published medical literature for treatment options for each diagnosis, and it makes treatment suggestions to the physician together with diagnoses (Hagland, 2012). Having the ability to basically decipher through medical facility paraphrasing makes the physicians notes appealing as well.

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There are many components that could be outlined as a “major” CDSS component, but most are based on the actual computer programs now in existence.
Computerized systems and evidence-based medicine

Clinical decision support systems have been noted for the potential to reduce medical errors and increase health care quality and health provider efficiency (Sim, and Gorman, 2012). At the same time, evidence-based medical practices have become intensely popular and highly promoted. According to Sims and Gorman (2012), “Evidence-based medicine is the management of individual patients through individualized expertise which is integrated with conscientious and current evidence clinical care research” (Journal of American Medical Informatics Association, pp. 527, para. 1). Evidence-based medicine therefore substantially will improve health care quality based on the best available scientific evidence.
Utilizing a CDSS will only be effective as the information that is entered and the strength of the evidence base. This approach according to Kenny Thomas (2013), “Is only as effective as the CDSS’s and will be limited by any deficiencies in the quality or relevance of the research evidence, but more high-quality, useful, and actionable evidence that is up-to-date, easily accessible, and machine interpretable” (Journal of medical internet research, pp. 3, para. 4).

Conclusion

The actual term Clinical Decision-Support Systems means different things to different individuals. The CDSS goes beyond just drug to drug interactions and allergy checking. The implementation of a CDSS is required and essential for the future of quality of patient care. CDSS is a real-time list of diagnoses for easy treatment of patients and handling workflow. CDSS is here to make advancements in health care in the year 2014 and beyond.



References

Hagland, M. (2012). Second-generation clinical decision support. Healthcare
informatics journal. 29(3-20). Doi: 78276884
Sim, S., and Gorman, L. (2012). Clinical decision support systems for the practice of
evidence-based medicine. Journal of American Medical Informatics Association.
8(527–534). Retrieved from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC130063/
Thomas, K. (2013). Evaluation of internet-based clinical decision support systems.
Journal of medical internet research. 4 (1-15). doi: 10.2196/jmir.1.2.e6
Yuan, M. (2011). How natural language processing and semantic search could
revolutionize clinical decision support. Developer works journal. 3(5-10).
Retrieved from http://www.ibm.org /developerworks/library/os-ind-watson/




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