Nonintrusive CDS tool enhances communication, improves outcomes

An integrated and workflow-aware clinical decision support (CDS) tool is "critical" to improving patient/provider communications and influencing patient outcomes, according to a new study in eGEMS (Generating Evidence & Methods to Improve Patient Outcomes).

CDS tools can be effective, but usually only target an individual risk factor. To that end, researchers from Ohio State University designed the Stroke Prevention in Healthcare Delivery Environments (SPHERE) tool to aggregate and display data relevant to cardiovascular health together, making it relevant to patients and providers. The aim of the tool was to create more discussions on stroke prevention, effect corresponding behavior change and treat risk factors, such as smoking and weight. The alert, created using user-centric design (UCD), was nondisruptive, provided automatic data retrieval and a non-intrusive view.

Other studies have shown that CDS tools, particularly customized ones, can greatly improve patient care. Even using a simple vaccination alert can have a positive impact on patient health.

The researchers tested the tool at two outpatient settings at Ohio State University's Wexner Medical Center, finding that providers had a "high" level of satisfaction. What's more, patient outcomes in some metrics, such as body mass index and diabetes, improved. Some challenges were noted by the researchers, including the small sample size, since the tool was only used in about 6 percent of eligible patient encounters; some Internet browser compatibility problems; and multiple alerts that interfered with each other. They also pointed out that CDS tools must periodically be evaluated.

"As the healthcare landscape and EHR usage continue to evolve, we must employ an iterative design and development process to keep SPHERE and other such applications up to date and useful," the authors said. "Reimbursement changes, new guidelines and technological updates are just some of the many factors that can have an impact on provider usage of SPHERE. Continuous evaluation and refinement keep CDS systems relevant and meaningful."

To learn more:
- read the study (.pdf)

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