Benefits of clinical decision support systems (CDSS)
The clinical decision support system is much more than just automatic alerts and reminders. When a clinical decision support system is applied effectively, it increases the quality of care, enhances health outcomes, helps to avoid errors and adverse events, improves efficiency, reduces costs, and enhances provider and patient satisfaction.
Patient safety
The use of clinical decision support reduces medication errors and possible adverse events. For example, errors involving drug-drug interactions (DDI) are cited as common and preventable, with up to 65% of inpatients being exposed to one or more potentially harmful combinations. Clinical decision support can also improve patient safety through reminder systems for other clinical events, not just medication-related ones.
Clinical management
Studies have shown that clinical decision support can increase adherence to clinical guidelines. CDS can also alert clinicians to reach out to patients who have not followed management plans or are due for a follow-up and help identify patients eligible for research based on specific criteria.
Healthcare costs
Clinical decision support can be cost-effective for health systems through clinical interventions, decreasing inpatient length of stay, suggesting more optimal medications, or reducing test duplication. Clinical decision support can notify users of cheaper alternatives to drugs or conditions that states or insurance companies will cover.
Quality of documentation
Clinical decision support strengthens clinical and diagnostic coding, prescription of procedures and tests, and patient triage. CDSS can directly improve the quality of clinical documentation (e.g., using correct codes for drugs, diagnosis, procedures).
Diagnostics
Clinical decision support can help with differential diagnosis, providing data or user selections and then outputting a list of possible or probable diagnoses.
Connecting focused patient data reports to clinical guidelines
The exponential growth of medical knowledge has created a market for dynamic and syntheses products for healthcare professionals.
- It is estimated that the doubling time of medical knowledge in 2020 is projected to be just 73 days. Students who graduate in 2020 will experience four doublings in expertise. What was learned in the first three years of medical school will be just 6% of what is known at the end of the decade from 2010 to 2020 (Densen et al., 2011).
Knowledge is expanding faster than our ability to assimilate and apply it effectively. Doctors increasingly rely on health information technology to accelerate the search process without compromising the reliability and quality of information retrieved.
Point-of-care (POC) clinical databases offer predigested syntheses of evidence-based medical research intended to be used when the patient and physician interact. Point of care (POC) clinical databases provide user-friendly interfaces that may improve the retrieval, synthesis, organization, and application of evidence-based content in clinical practice.
Contextually relevant reference information at the point of care
The content of point of care (POC) clinical databases can be implemented as clinical decision support in your electronic health record, pharmacy information system, or nationwide e-prescription system. The implementation process will combine focused patient data reports with clinical guidelines and other contextually relevant reference information.
What is an example of clinical decision support?
Get an overview of a selection of evidence-based databases in the Synbase platform:
- Drug interactions
- Drugs in pregnancy
- Drug dosage in renal failure
- Drug dosage in hepatic failure
- Drug allergies
- Natural medicines
- Evidence-based guidelines
- Clinical reference tool
- Dentistry database
- Clinical decision support
- Differential diagnosis
- Patient solutions
Customers and use cases of CDSS
Clinical decision support system receives structured health data from patient-related health repository. It returns a structured decision-support response message to the electronic health record (EHR), hospital information system (HIS), pharmacy point-of-sale (POS), personal health record (PHR), or other similar health info system.
Get an overview of clinical decision support use cases in the Synbase platform:
- For public sector
- For electronic health record
- For pharmacy
- For dental practice
- For individual users
- For medical publishers
Guide for successful CDSS implementation
Here are some practical tips for successful clinical decision support system implementation.
Be user-centric
Clinical decision support aims to help clinicians in clinical decision-making. Our strong recommendation is to use a user-centered design (UCD) process for implementation. At each stage of the implementation process the user needs, clinical workflow, and service process are given extensive attention. Users should be involved already starting from pre-planning activities.
Find your clinical champions
The healthcare sector is conservative; never underestimate resistance to change. Like with every technology adoption cycle, there are visionaries, pragmatists, conservatives, and skeptics. Focus on shared values and find the clinical champions that will guide you through. Effective clinical champions are tech-savvy members of the organization whom their peers trust, understand their colleagues’ technical and workflow challenges, and have strong interpersonal skills.
Start simple
Start simple and focus on an “easy win” in clinical goals and objectives and corresponding clinical decision support interventions. Implementation is challenging both technically (health data interoperability) and from a user perspective. A good recommendation is to start with a feasibility study. Start with simpler one domain clinical decision support like drug-drug interaction checking and move to more complex services.
For starters, get an overview of drug interactions services:
- Drug interactions
- How to Implement Nationwide Drug Interaction Service
Right person, right time, right info
For successful clinical decision support system implementation, follow these three design principles.
- Right person – only person-specific information should be presented to users
- Right time– customized alerts, and reminders should be presented to users at appropriate times before making the clinical decision
- Right data– patient-related data reports should relate to the latest clinical knowledge and intelligently filtered
Engage your users
Collecting feedback after implementation is just as crucial as getting stakeholder input before going live. Measuring the impacts on workflow, patient safety, care quality, and provider or patient satisfaction can help inform future efforts and make positive changes to the process.
Do you want to implement clinical decision support as a nationwide service?
Get advice on how to implement clinical decision support in European Union, including medical device regulation (MDR) related compliance. Get in touch >
Compliance with medical device regulation (MDR)
Since clinical decision support systems fall under the classification of IIa medical devices, implementing a decision support tool in European Union must be done following the requirements set in the new Medical Device Regulation (MDR) 2017/745 that entered into force on the 26th of May 2021.
The new regulation has changed the way medical devices are classified – new rules are being applied to software-based devices, devices consisting of nanomaterials, invasive devices meant for inhalation, devices consisting of substances or mixtures of substances, and therapeutic devices.
In addition, MDR 2017/745 has introduced a Unique Device Identification (UDI) system and the European Database of Medical Devices (EUDAMED).
Other changes include the addition of the terms “importer” and “distributor” and changes in the obligations of importers and distributors, as well as stricter post-market surveillance requirements.
What is your role in implementing clinical decision support?
- A manufacturer is a natural or legal person who manufactures or fully refurbishes a device or has a device designed, manufactured, or fully refurbished and markets that device under its name or trademark.
- An authorized representative is any natural or legal person established within the European Union who has received and accepted a written mandate from a manufacturer located outside the EU to act on the manufacturer’s behalf in relation to specified tasks regarding the latter’s obligations under this regulation.
- An importer is any natural or legal person established within the European Union that places a device from a third country on the EU market.
- A distributor is a natural or legal person in the supply chain, other than the manufacturer or the importer, that makes the medical device available on the market up until the point of putting it into service.
How to register clinical decision support as a medical device?
The deadline for all medical device parties (manufacturers, authorized representatives, importers, system/procedure package manufacturers) for mandatory registration with EUDAMED is the 26th of May 2022, when the database is expected to become fully functional.
