AC Group, Inc. is conducting a brief survey of Clinical Decision Support functionality. Please submit your responses by January 31, 2008. The results of the survey will be presented in a white paper and distributed at HIMSS, AMGA, TEPR and MGMA in 2008.
The electronic health record is often positioned as a solution for improving the quality of patient care.However, in a recent analysis of ambulatory visits, the implementation of the electronic health record by itself was not associated with higher quality care (1).Therefore, the electronic health record’s potential to improve quality falls on its ability to incorporate clinical decision support tools (eg, reminders and alerts, order sets, health maintenance and disease management dashboards) at the point of care, as well as supply the library of evidence-based content supporting these tools.
A key consideration is how the decision support affects clinician workflow.EHRs that only provide access to referential decision support content (eg, Web-based search engines, electronic textbooks) will fall short in improving clinical practice because this approach interrupts clinician workflow.In a meta-analysis of clinical decision support systems, the automatic provision of decision support as part of clinician workflow and provision of decision support at the time and location of decision making were identified as key features that predicted a clinical decision support system’s ability to improve patient care (2).In other words, the decision support must come automatically, at the right time and place, without disrupting the clinician.
In addition to its effect on quality, clinical decision support is having an increased financial impact. With the recent growth in pay-for-performance programs, physician compensation is increasingly linked to clinical processes and outcomes.This trend is expected to continue, and physicians must prepare now for this shift.EHR vendors should begin to incorporate point of care decision support content and tools that enable clinicians to make evidence-based treatment decisions that improve both patient care and their bottom line.