Plan for Clinical Decision Support

Introduction

Clinical decision support (CDS) offers patients, staff, and clinicians person-centered information that is diligently designed and presented at the right time to promote healthcare. CDS is an integral part of the electronic health record (EHR) and is gradually being implanted in the health information exchange (HIE) services (Nelson & Staggers, 2014). It is considered a milestone for EHR, which assist in enhancement of cost and quality of care.
1. The approach you would take to ensure all aspects of patient care are considered

To ensure that all aspects of patient care are considered, the CDS should ensure that stakeholders are engaged; goals are translated and guarantee that EHR is adherence to interoperability standards to minimize errors in presentation of alert. Stakeholders’ engagement is essential because it would assist people who are directly or indirectly using the system to comprehend their responsibilities in planning for clinical decision support use (Nelson & Staggers, 2014). In addition, they would create goals for utilization of CDS and provide a platform for expressing their use concerning the CDS. Moreover, translation of the goals regarding the CDS should explain actions users are anticipated to acquire when obtaining the alerts (Musen, Middleton & Greenes, 2014).
2. Define and describe a minimum of five CDS supports you would include

Some of the CDS support would include reminders and alerts interventions, guidance and reference information, pathway/protocol supports, prescription creation facilitators, and presentations of appropriate data/information. Alerts deliver instant notification of hazards and errors associated to new orders or data provided by CIS especially when unusual lab results emerge. It would assist in administering standards of care (Musen, Middleton & Greenes, 2014). Secondly, guidance and information reference handle the acknowledge information needs of clinicians and patients. Thirdly, pathway/protocol support offers help for various care protocols, pathways, and plans that prolong over time. Fourthly, prescription creation refers to information regarding order of prescriptions. It would assist in compliance with care standards by facilitating easier adherence to recommended prescriptions. Fifthly, presentation of relevant data would optimize decision making by guaranteeing all crucial information are organized to help in easier comprehension of general clinical picture and to point out needed actions (Nelson & Staggers, 2014).
3. How you would prioritize the efforts

To optimize the efforts, the clinician would collaborate with the National Academy of Medicine (NAM) to facilitate engagement with special experts and initiate a wide range of recommendations and strategies to maximize CDS in promotion of improved care. The goals of the project would be to highlight actionable chances to stimulate progress in establishment, distribution, and utilization of CDS, and encourage achievement on priority among varios stakeholders groups. It would also motivate development towards an interoperable and usable CDS (McIntyre, Shamir & Walter, 2017).
4. Potential areas to focus on that are related to payment rates, national quality measures, CDS interventions that meet meaningful use requirements, readmissions for congestive heart failure and other care events, and areas identified as institutional priorities for clinical improvement

The potential areas of focus include the use of technologies related to health information that would meet the standards of payment, national quality measures, CDS intervention that meet meaningful use requirements, readmissions for congestive heart failures and other care events (McIntyre, Shamir & Walter, 2017). Such kind of technology is designed to strengthen clinical decision making which assist to challenge the information overload that clinicians experience. In so doing, it assist to enhance the quality of health outcomes and care, minimize preventable medical errors and enables quicker access to records via HER which enables patient information sharing using HIE tool (Nelson & Staggers, 2014).
5. How you would balance the need to deliver the CDS capabilities quickly against the benefit of establishing a robust infrastructure

To balance the need to deliver the CDS capabilities quickly against the benefits of establishing a robust infrastructure, the planner must utilize a network-based approach to clinical decision support. It also initiates substantial latency that could be a challenge for point-of-care and time-sensitive CDS applications (McIntyre, Shamir & Walter, 2017). For instance, CDS capabilities could be balanced with CDS web. The fundamental potential advantage of utilizing a system-agnostic CDS service is the flexibility and ease with which the service can be leveraged to execute CDS capabilities across care settings and applications (Nelson & Staggers, 2014). It promotes a centralized management of knowledge and sharing information.
6. Identify one area for quality and improvement and what CDS strategies you would implement to improve that area

One area for quality and improvement is reducing the rate of false-positives witnessed in the health facility. In this regard, the EHR would utilize CDS strategy that focuses on decrease of the proportion of medical errors. In this regard, facts regarding the current health condition of the patient that can affect his/her safety would be delivering via the EMR in the radiology and labs departments. The CDS system would have the capacity to accurately interpreting the information provided and retrieve it easily.
7. Define how your approach aligns with best practices such as CDS Five Rights, CDS 10 commandments, and the desire to use standards-based scalable approaches

Provision of facts regarding the current condition of the patient aligns with the best practices such as CDS Five Rights because it guarantees the right information, the right person, the right intervention format, the right channel, and the right time in workflow (Vyas, Paithankar & Joshi, 2017). For instance, to eliminate the problem, the CDS would be executed using the appropriate format such as protocols, order sets, and alerts.
It also meets the Ten Commandments for efficient CDS system by ensuring speedy delivery of information, provision of information at the time it is required, integrating proposals with practice, and ensuring that the clinicians engage in the right thing (Nelson & Staggers, 2014). It would also ensure utilization of standard-based scalable approach, which includes standard information and terminologies models to communicate and represent data regarding health. Facts about health condition would also provide standard approach to demonstrate clinical information machine-executable and human-readable formats (Vyas, Paithankar & Joshi, 2017).

8. How you will systematically measure the effects of CDS interventions

To guarantee that CDS is meeting its objective of enhancing care outcomes and processes, it affects should be measured (Vyas, Paithankar & Joshi, 2017). The systematic measure would be conducted through CDS usability, usage, and satisfaction from the feedback of end-users and logs.  Secondly, workflow efficiency and impact would be measured using time for medication turn-around and direct order entry. Thirdly, CDS use would be assessed using alert overrides, alerts firing rates, and alert use from clinicians. Fourthly, efficiencies and utilization of healthcare services would be assessed through drops in inappropriate or unnecessary lab or radiology test orders (Nelson & Staggers, 2014).

References

McIntyre, C., SHamir, R. R., & Walter, B. L. (2017). U.S. Patent No. 9,764,136. Washington, DC: U.S. Patent and Trademark Office.

Musen, M. A., Middleton, B., & Greenes, R. A. (2014). Clinical decision-support systems. In Biomedical informatics (pp. 643-674). Springer, London.

Nelson, R., & Staggers, N. (2014). Health Informatics-E-Book: An Interprofessional Approach. Elsevier Health Sciences.

Vyas, N., Paithankar, K., & Joshi, S. (2017). A Novel Approach for Design of Ontology Based Clinical Decision Support System. International Journal of Advanced Research in Computer Science, 8(1).