This is the reading note for HlthInfo730 Week1 reading, Effect of Clinical Decision-Support Systems: A Systematic Review.
Motivation
To find evidence of the effects of Clinical Decision-Support Systems(CDSS), to support widespread use of it.
Defining CDSS
A CDSS is “any electronic system designed to aid directly in clinical decision making, in which characteristics of individual patients are used to generate patient-specific assessments or recommendations that are then presented to clinicians for consideration”
Classic CDSSs
- Classic CDSSs have
- alerts,
- reminders,
- order sets,
- drug-dose calculations,
to automatically remind the clinician of a specific action, or care summary dashboards that provide performance feedback on quality indicators.
- Information retrieval tools, such as an “infobutton” embedded in a clinical information system, are designed to aid clinicians in the search and retrieval of context-specific knowledge from information sources based on patient-specific information from a clinical information system.
- Knowledge resources, such as UpToDate, Epocrates, and MD Consult, consist of distilled primary literature that allows selection of content germane to a specific patient to facilitate decision making at the point of care or for a specific care situation.
Assessing Outcomes of CDSS
The research looks for the following types of CDSS’s outcomes:
- Clinical Outcomes
- length of stay,
- morbidity (CDSSs improved morbidity outcomes),
- mortality (CDSSs have low impact),
- health-related quality of life,
- adverse events (low impact)
- Health care process
- Recommended Preventive Care Service Ordered or Completed (significant impact)
- clinical study,
- treatment ordered or completed
- User workload and efficiency (user knowledge, number of patients seen, clinician workload, and efficiency),
- Relationship-centered (patient satisfaction),
- Economic (cost and cost-effectiveness),
- Use and implementation by a health care provider (acceptance, satisfaction, use, and implementation).