Community hospitals catching up on clinical decision support

The future of clinical decision support systems at community hospitals shows promise based on the success of hospitals that have already installed the technology, a study published online this week in the Journal of the American Medical Informatics Association concluded.

Researchers analyzed survey results from 34 community hospitals that adopted the technology in the past five years.

The findings are especially important in light of the requirements for decision support under Meaningful Use. Although the rules for adopting decision support are "minimally prescriptive," hospitals are on a "good track" toward required governance, the researchers said.

"Nearly all hospitals had developed a level of sophistication that appeared similar to that of the relatively highly regarded VA system," the researchers said. "This finding bodes well for hospitals of all sizes and types … that are striving toward meeting the increasingly difficult Meaningful Use requirements."

VA hospitals, the researchers pointed out, are ineligible for Meaningful Use incentives. Nevertheless, representatives from nine VA facilities said they believed they would be able to meet the criteria for such requirements, if necessary. For instance, all nine VA hospitals surveyed attested that more than 88 percent of their medication, lab and radiology orders were entered using computerized physician order entry (CPOE).

While 86 percent of U.S. hospitals are community hospitals, fewer than 7 percent use a basic clinical information system, the researchers noted.

Although clinical decision support can help hospitals to improve care, it is far from a silver bullet for reducing errors. A study published earlier this spring, also in JAMIA, found data-driven and adaptive clinical decision support to be more reliable than some existing methods, which implies that not all systems are equally reliable.

Meanwhile, Stanford University researchers in January 2011 concluded that CDS support wasn't necessarily associated with higher-quality care.

To learn more:
- read the full JAMIA study

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