Clinical Decision Support: A Practical Guide to Developing Your Program to Improve Outcomes

Robert A. Jendersab, Jerome A. Osheroff, MDc, Jonathan M. Teichd, Dean F. Sittige

a Center for Biomedical Informatics, Charles Drew University, Los Angeles, California, USA

b Department of Medicine, University of California, Los Angeles, USA

c TMIT Consulting and University of Pennsylvania, Cherry Hill, New Jersey, USA

d Elsevier Health Sciences and Harvard University, Newton, Massacusetts, USA

eSchool of Biomedical Informatics, University of Texas - Houston, Texas, USA

 

Abstract

This tutorial will provide attendees with a practical approach to developing and deploying clinical decision support (CDS) interventions that measurably improve outcomes of interest to a health care delivery organization. The speakers will address both foundational capabilities for building successful CDS program as well as practical details for selecting, configuring, deploying and monitoring outcome-improving interventions. This systematic approach to CDS implementation will be presented in an interactive, “case-oriented” fashion, incorporating examples provided by tutorial leaders and participants’ experiences. The course content is drawn in part from the tutorial leaders’ award-winning book, “Improving Outcomes with Clinical Decision Support: An Implementer’s Guide.” Tutorial faculty members will provide an international perspective through their work with standards development organizations and other leadership roles. The speakers will describe approaches to CDS that can be used by workers at health care organizations with clinical information systems ranging from the limited to the complex. A small-group exercise will allow participants to apply this knowledge to practical problems.

The first part of the tutorial will be delivered as an integrated series of slide-based lectures by all of the tutorial faculty members. This will be followed by a division of attendees into small groups, each of which will apply this process with the assistance of faculty members against a sample clinical objective, putting the didactic material into practice.

The speakers will address a number of themes regarding CDS, including developing governance structures, stakeholder engagement and other key requirements for implementing a CDS program; selecting CDS goals; implementing CDS interventions that improve outcomes; monitoring and measuring CDS interventions; knowledge management and the refinement of CDS interventions based on results; national programs relevant to CDS, including knowledge sharing, clinical guidelines and meaningful use; and medico-legal considerations in the use of CDS.

Outline of Topics

  • Developing effective governance structures, stakeholder engagement and other key requirements for implementing a CDS program.

  • Selecting CDS goals.

  • Implementing goal-directed CDS interventions that improve outcomes, including the “CDS Five Rights”.

  • Monitoring and measuring CDS interventions.

  • Knowledge management and the refinement of CDS interventions based on results.

  • National programs relevant to CDS, including knowledge sharing, clinical guidelines and meaningful use.

  • Medico-legal considerations in the use of CDS.

 

Learning objectives

At the conclusion of this tutorial, participants will understand a systematic approach to addressing key health care organizational goals through a CDS program; understand the broad range of potential CDS interventions and opportunities to use them to accomplish specific objectives; and be able to describe individual techniques and considerations for overcoming organizational and technical barriers to successful CDS.

 

Targeted audience

Clinicians and administrators from health care organizations interested in CDS deployment, including both those contemplating and undertaking the process, will find the tutorial valuable.  Pertinent roles include those responsible for CDS such as managers and directors of clinical information systems, and clinicians and administrators associated with CDS projects.  Representatives from organizations both with and without robust clinical information systems (e.g. EHR and CPOE) will benefit.  CDS researchers and clinical information system vendors also will find the material of interest.  Computer scientists, system developers, service suppliers and programmers interested in understanding applications of health information technology to CDS also will benefit.

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