CDS tools must mitigate 'fog of war,' prevent info overload

Better clinical decision support tools embedded in electronic health records can help clinicians manage complex healthcare issues in patients, according to a recent study.

How clinical experts use cognitive thinking to deal with complicated situations can help inform future design of information technology systems, say the authors of the study, published at BMC Medical Informatics and Decision Making.

The researchers, from the University of Utah and the VA Salt Lake City Health System, interviewed 10 infectious disease experts at their institutions. Those 10 experts were asked to describe a complex diagnosis or treatment action and the thinking behind the decision.

Some issues the clincians cited when making such a decision included a lack of conflicting indicator data, lack of evidence about treatment effectiveness, lack of diagnosis and gaps in their own knowledge.

To help better support clinicians and provide them with information they lack, EHRs need clinical decision support (CDS) systems designed to "provide users a comprehensive view that mitigates the 'fog of war' without overloading them with information," the authors write.

CDS systems could include better patient monitoring tools, improved documentation, better visualization and population-based decision support. Such tools embedded in EHR systems "can facilitate clinicians' high-level reasoning," the authors conclude.

This isn't the first research paper touting the need for better CDS in EHRs. In a paper published in the Journal of Medical Internet Research in October, researchers from Beth Israel Deaconess Medical Center and Yale University said tools needed include data incorporation, enhanced monitoring systems and formulation of doctors' notes in real-time.

In addition, CDS tools have helped to improve the accuracy and safety of prescribing drugs to patients with kidney disease, as well as enhance patient/provider communications.

To learn more:
- here's the study

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