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THE CLINICAL DECISION SUPPORT SYSTEM FOR DRUG ALLERGY CHECKING.HOW COMPUTERIZED PROVIDER ORDER ENTRY ( CPOE)SYSTEM WITH BUILT-IN CLINICAL SUPPORT SYSTEM (CDSS) HAVE THE POTENTIAL TO PREVENT MEDICATION ERRORS AND ADVERSE EVENTS.
Recall that Clinical Decision Support uses “computable biomedical knowledge, person-specific data, and a reasoning or inferencing mechanism that combines knowledge and data to generate and present helpful information to clinicians as care is being delivered.” *
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THE CLINICAL DECISION SUPPORT SYSTEM FOR DRUG ALLERGY CHECKING.HOW COMPUTERIZED PROVIDER ORDER ENTRY ( CPOE)SYSTEM WITH BUILTH-IN CLINICAL SUPPORT SYSTEM (CDSS) HAVE THE POTENTIAL TO PREVENT MEDICATION ERRORS AND ADVERSE EVENTS.
QUESTIONS:
Describe a clinical decision support system you have used or have read about.
Review the benefits/barriers of the clinical decision support system.
Discuss any unintended consequences after the implementation of the system.
Search the literature and find one article describing the adoption of a similar clinical decision support system. Summarize the key points of the article.
*Clinical Decision Support. (2018, April 10). Retrieved from https://www.healthit.gov/topic/safety/clinical-decision-support.
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How Computerized Provider Order Entry (CPOE)System with Built-In Clinical Support System (CDSS) have the Potential to Prevent Medication Errors and Adverse Events
Clinical Decision Support System
CPOE is a system that allows practitioners to use computers to electronically enter medical orders directly in healthcare settings. CPOE application allows healthcare providers to enter medication orders, radiology, laboratory, procedure, referral, and admission orders directly (Légat et al., 2018). A CDSS is a system that analyses information and thus assists healthcare providers when making clinical decisions and improves patient care. A CDSS utilizes knowledge management to obtain clinical advice according to various factors related to patient data. A CDSS enables integrated workflows, provider recommendations about care plans, and assists in care provision (Légat et al., 2018). Therefore, a CPOE with an in-built CDSS allows healthcare providers to enter medical orders electronically based on information/advice from the CDSS system.
Benefits/Barriers of the Clinical Decision Support System
The clinical decision support system improves the quality of care, medication safety, improves the efficiency of hospital operations, and also ensures that healthcare providers adhere to the appropriate clinical guidelines. Additionally, CDSS can decrease the cost of healthcare. The CDSS improves the quality of care and patient safety by ensuring that healthcare providers make legible and correct medical orders (Légat et al., 2018). This is because the CDSS provides healthcare providers with real-time support information about treatment and diagnosis and also provides tools that improve patient care, reduce medical errors, and lower healthcare costs. Additionally, CDSS may include rules that require healthcare providers to check for drug allergies, drug-drug interactions, weight-based dosing, and any drug interactions, further improving safety (Légat et al., 2018). The main barrier to implementing CDSS in healthcare organizations may include a lack of skills to operate the CDSS, for the healthcare providers. However, this barrier can be overcome by training healthcare providers.
Unintended Consequences after the Implementation of the System
Some of the unintended consequences of CDSS include eliminating human roles where the pharmacists and nurses do not have to double-check medical orders. The CDSS can also create false negative or positive alerts that can result in patient safety issues. Studies also show that CDSS can lead to changes in communication patterns, overdependence on technology, changes in the power structure, and constant requirement to update the system (Stone, 2018).
Summary of the Article
The article focuses on the implementation of the Clinical Decision Support System Reference Model (CDSS-RM). The model is used in a hospital setting to decide regarding patient diagnosis and treatment (Zikos & DeLellis, 2018). The system guides healthcare providers when selecting suitable diagnostic tests, make patient’s diagnoses, select optimal treatments, and predict patient diagnosis. According to Zikos & DeLellis (2018), the CDSS model should include the cognition element because it is important for healthcare providers to assess healthcare information with cognitive skills; allow information sharing across the healthcare system and between healthcare providers; and allow reuse of the health data when making various clinical decisions (Zikos & DeLellis, 2018). CDSS systems should stimulate the thinking and cognitive skills of clinical decision-makers because health information is useful and valuable when integrated with human knowledge and experience.
References
Légat, L., Van Laere, S., Nyssen, M., Steurbaut, S., Dupont, A. G., & Cornu, P. (2018). Clinical Decision Support Systems for Drug Allergy Checking: Systematic Review. Journal of medical Internet research, 20(9), e258. https://doi.org/10.2196/jmir.8206.
Stone, E. G. (2018). Unintended adverse consequences of a clinical decision support system: two cases. Journal of the American Medical Informatics Association, 25(5), 564-567.
Zikos, D., & DeLellis, N. (2018). CDSS-RM: a clinical decision support system reference model. BMC Medical Research Methodology, 18(1), 137.