Clinical Decision Support (CDS)

What is it?

• CDS is defined as providing clinicians or patients with clinical knowledge and intelligently filtered patient information to enhance patient care.¹ CDS delivers information highly relevant to the current situation, and presented for the most effective use.²
• CDS includes: alerts and reminders, clinical guidelines, order sets, patient data reports and dashboards, documentation templates, diagnostic support, reference information delivered, and other tools to support decisions within clinical workflow.

Goals of CDS

• Provide the right information, to the right person, in the right format, through the right channel, at the right point in clinical workflow to improve health and healthcare decisions and outcomes.²
• CDS interventionscan:
  • Detect potential safety and quality problems and help prevent them
  • Detect inappropriate utilization of services, medications, and supplies
  • Foster the greater use of evidence-based medicine principles and guidelines
  • Organize, optimize and help operationalize the details of a plan of care
  • Help gather and present data needed to execute this plan
  • Ensure that the best clinical knowledge and recommendations are utilized to improve health management decisions by clinicians and patients

Does CDS work?

• CDS helps the practice of medicine in a multitude of ways, including, but not limited to: preventing errors or adverse events, improving compliance with care guidelines, and improving test ordering.
• Two examples of impact:
  • For medications, the effect on use might include suggesting brand to generic substitutions for medications; alternative, more cost-effective therapies, or more formulary compliant drug options.² Selecting complex dosages (renal failure or geriatrics) and supporting drug-level monitoring are additional advantages of CDS.
  • For expensive radiologic tests and procedures this support at the point of ordering can guide physicians toward the most appropriate and cost effective, radiologic tests.³

References

1   Osheroff JA, Teich JM, Middleton BF, et al. A Roadmap for National Action on Clinical Decision Support. June 13, 2006. (Available at www.amia.org/files/cdsroadmap.pdf) J Am Med Inform Assoc. 2007;14:141-145. DOI 10.1197/jamia.M2334.

2   Osheroff JA, Pifer EA, Teich JM, et al. Improving Outcomes with Clinical Decision Support: An Implementers’ Guide. Chicago: HIMSS; 2005.

3   Osheroff JA, editor. Improving Medication Use and Outcomes with Clinical Decision Support: A Step-by-Step Guide. Chicago: HIMSS; 2009. (www.himss.org/cdsguide)