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Clinical Decision Support: Not Just Another Alert

Clinical Decision Support (CDS) is fascinating, crucial, and often underappreciated. My definition of CDS is any tool used to aid a provider in making a clinical decision. A common definition used in the industry is that CDS “provides clinicians, staff, patients, or other individuals with knowledge and person-specific information, intelligently filtered or presented at appropriate times to enhance health and health care.” (Osheroff et al, 2006). CDS is not always electronic, and it isn’t just for doctors and pharmacists. The definition above details that it is for anyone who accesses the health record and who needs to make a health-related decision – including patients.  Investigate600

Often when providers hear “clinical decision support,” they think of the many alerts they receive whenever they interact with the electronic health record (EHR). In fact, there are over 53 types of clinical decision support divided into six categories: medication dosing support, order facilitators, point-of-care alerts/reminders, relevant information display, expert systems, and workflow support. Some examples include medication pick lists, order sets, drug-drug interactions, info buttons, logic-based diagnostic tools, documentation templates, and so much more.

Electronic health records and computer-based documentation have been adopted in over 90% of health care settings. Because of this, there are numerous opportunities for health care systems to improve quality and value through CDS solutions. But to do this effectively, CDS tools must be designed and implemented according to best practices and guidelines.
This brings me to the five rights of clinical decision support, coined by Jerry Osheroff in 2005 and still very relevant today. They are:  

The right information
To the right person
In the right format
Through the right channel
At the right time in workflow

The five rights are necessary because they guide CDS implementation and put the decision maker’s needs before anything else. Therefore, if you work on CDS tools, these five rights should be at the forefront of your mind. For example, our team develops content for the 3M/MModal Clinical Document Improvement (CDI) products. I must remember that what I am building (which may seem impossibly far from the bedside) will help generate the right information for the provider, so it drives me to help the product (the right channel) delivered in the right format at the right time in their workflow.

If the team can help your terminology adoption projects, please contact us.