Rely on governance, tools to keep clinical decision support up to date

Beyond implementing clinical decision support tools, keeping the content current remains a weighty responsibility, one that must be tackled with proper governance and technology, according to an Executive Insight article.

With greater emphasis on evidence-based medicine, tools must provide the most current clinical advice at the point of care.

To effectively manage the clinical knowledge embedded in CDS applications requires leadership and a formal strategy, as well as tools to automate as much as possible, according to the article.

Close collaboration between clinical and IT leaders is required to ensure the ongoing quality of the information, but also how it is used in various systems. Physicians need to take ownership of the clinical information, including order sets, care plans, rules and alerts, surveillance tools and more, author Linda Peitzman, M.D., said.

Among her recommendations:

  • Set up a governance committee involving clinical and IT leaders. Members of the health information management department also can play a role in ensuring the right information is captured for coding and billing.
  • Define a process for regular review. While some clinical content might need to be reviewed only annually, other constantly evolving areas, such as cardiac or cancer care, might need to be updated far more frequently.
  • Assess the proper technology. A key factor is whether your vendor allows your organization to take full ownership of their content. Some insist upon control over modifications or updates by the customer.

While CDS offers the potential to deliver best-practice advice at the point of care, technology and physician practice must evolve to make that happen, according to a recent study at BMC Medical Informatics and Decision Making.

Patient perceptions are but one barrier, according to University of Missouri research that found physicians who use CDS tools are seen as less capable.

Physicians and nurses as well have preconceived ideas about using CDS tools, but a study from The Netherlands found that biases fade the more they learn about the systems.

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