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2011 CMIO Summit | Don Levick
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2011 CMIO Summit | Don Levick

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  • 1. Where to Start and Where to Go Don Levick, M.D., MBA Medical Director Clinical Informatics
  • 2.  Clinical Decision Support is a process for improving health-related decisions and actions with pertinent, organized clinical knowledge and patient information. Information delivered can include a mixture of general clinical knowledge and intelligently processed patient data.Adapted from: Improving Outcomes with Clinical Decision Support: An Implementer’s Guide, Second Edition; HIMSS Press, in preparation
  • 3.  Drug-Drug Interactions  Diagnostic decision support Drug-Allergy interactions tools Dose Range Checking  Links to knowledge references (eMedicine, Standardized evidence National Comprehensive based ordersets Cancer Network ) Rules to meet strategic  Links to local policies objectives (core measures, antibiotic  Point of care reference usage, blood information (i.e. management) InfoButtons) Documentation templates  Web based reference information Relevant data displays
  • 4.  Successfully applying CDS to improve a targeted objective requires that the ◦ right information be delivered to the ◦ right person in the ◦ right intervention format through the ◦ right channel at the ◦ right point in workflow.
  • 5. • CDS should be used as a strategic tool for achieving an organization’s priority care delivery objectives.• These objectives are driven by:  Internal needs (PI/QI, Med error reduction)  External forces (Meaningful Use, P4P, TJC)
  • 6.  “Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance to that rule.” ◦ Must use patient-specific information to offer diagnostic or treatment options to the provider within its logic. ◦ It must be conditional: the rule will produce a different action or different information, based on the patient- specific information. http://www.himss.org/content/files/CDS_MU_FAQ.pdf
  • 7. • CDS interventions will impact workflow throughout the organization; therefore leadership at all levels must understand and support the efforts• A high level understanding of a CDS program should include an understanding of the “Five Rights of CDS”• CDS programs require ongoing investment of capital and personnel• A champion is required to be a change agent and lead the charge
  • 8. • CDS should not be thought of as the only tool available to solve the organization’s problems.• There are clear limitations to CDS interventions
  • 9. • The value of the CDS program to the organization must be consistently and continually communicated at all levels• Successful CDS programs implement interventions WITH the stakeholders, and not TO the stakeholders• Be aware of the continuum of intrusion• Impact on workflow and screen response time• Close monitoring of all CDS must occur regularly to ensure validity. • “If it can’t be measured, it can’t be managed”• Be prepared to deal with resistors and detractors, including the ability to answer to negative articles in the literature
  • 10. Contact information: donlevick@ptd.net

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