KLAS: Integration still a barrier in CDS reference tools

Clinical decision support reference tools still lack the level of integration necessary to provide the strategic direction that providers need, according to the new KLAS report, "Clinical Decision Support 2013: Sizing Up Point-of-Care Reference Tools."

"Providers acknowledged the impact the tools are having and the efforts some vendors are making to leverage strategic partnerships, but declared that most products offered are still too much in silos," report author Adam Cherrington said in an announcement. "... though providers appreciated the high performance of most solutions, they felt that more portfolio integration would result in even greater impacts on patient care."

The report focuses on four groups of CDS tools: disease reference, drug reference, nursing reference and diagnostic decision support. Through interviews with providers, it evaluated each for impact on patient care, usability, perceived value and workflow.

Few healthcare organizations have CDS that goes beyond drug-drug interactions and drug-allergy contraindications, yet Meaningful Use Stage 2 requires that providers implement five clinical decision support interventions related to four or more clinical quality measures.

Implementing workable CDS in real-world healthcare settings isn't that easy, though. A study of rule-authoring tools used to convert medical knowledge into machine-executable CDS rules across Partners Healthcare in Boston found many limitations--and frustrations.

Research to date on whether CDS actually reduces inpatient costs so far hasn't provided that evidence, according to a recent study published at BMC Medical Informatics and Decision Making.

However, in previous interviews with providers, KLAS reported a majority said that CDS surveillance tools have a moderate to significant impact on clinical outcomes. That study evaluated pharmacy-focused surveillance, enterprise-wide surveillance and electronic medical record surveillance.

A bill introduced in the House last month--H.R. 3705--dubbed the "Excellence in Diagnostic Imaging Utilization Act"--would set appropriateness criteria for advanced imaging scans and mandate use of CDS software by physicians receiving Medicare and Medicaid reimbursement for those scans.

To learn more:
- find the announcement