Realize the Potential of Clinical Decision Support Systems

FIVE PRINCIPLES TO REALIZE THE FULL POTENTIAL OF CLINICAL DECISION SUPPORT SYSTEMS Clinical decision support (CDS) promises fewer medication errors, shorter length of stay. and greater patient safety. However, most organizations struggle with questionable data, alert fatigue, and unintended consequences. Leading CIOs apply five principles to realize the full potential of CDS. MINIMIZE ALERTS, MAXIMIZE GUIDANCE Abundance of low-probability alerts interrupts and distracts physicians Condition-specific guidance makes it easy to make good decisions, hard to make erroneous ones Stop interrupting and disrupting physicians-give them condition-specific guidance Context- Inappropriate Reminder Patient Comorbidities Erroneous Medication Disease- Specific Dashboard Allergy Unlikely Drug-Drug Interaction Relevant ! Intervention INCORPORATE PATIENT-SPECIFIC DATA Utilize multiple types of patient-specific data to boost value of CDS Lack of patient-specific data, resulting in canned alerts, suspect data, and low-probability risk factors. undermines physician trust Multiple-source patient-specific data reduces costs and improves outcomes CDS EFFECTIVENESS ELEMENTS OF PATIENT SPECIFIC DATA MANAGE LIFE CYCLE OF KNOWLEDGE Static data-management process fails to keep up with changing practice Managing the life cycle of knowledge ensures timely review and updates to keep CDS current Take responsibility for currency and accuracy of clinical knowledge incorporated into IT systems New CDS enters system TIME Order sets and rules accumulate New CDS built Unmanaged mixture of current and Obsolete CDs removed from system Accumulated CDS reviewed into system obsolete content ANTICIPATE UNINTENDED CONSEQUENCES Anticipate and track unintended Organizations are surprised by unintended consequences of electronic medical records implementation Anticipating process changes and reporting unintended consequences reduce harm to organization and patients consequences of computerization Frustrated Doctor Overtaxed Nurse CDS system implemented Unintended CDS system remains effective Unintended consequences events occur CDS system implemented CDS system anticipated breaks down Confused Patient APPOINT CLINICAL EXECUTIVES TO OWN CDS GOVERNANCE Hold senior clinical Mixed models and inconsistent clinical input lead to dysfunctional CDS governance Ownership by clinical executives permits appropriate targeting, ownership, and selection of CDS mechanisms executives accountable CDS EXECUTIVE OWNERS for working with IT to manage and govern CDS Dir. CNO Pharm. CMO CMIO Dir. Clinical Y systems MD Liaisons The Advisory Board Company IT Strategy Council LEARN MORE AT www.advisory.com/ITSC/poster2011 REALITY REALITY REALITY REALITY REALITY POTENTIAL POTENTIAL POTENTIAL POTENTIAL POTENTIAL