By Chris Cheney
An effective clinical decision support tool is available at the point of care, is as current as possible, and is accurate, a chief medical information officer says.
Medical knowledge advances rapidly, with a plethora of new studies published daily. Clinical decision support tools can help clinicians stay up to date with the constant changes of information about diagnoses and treatments.
A good clinical decision support tool has three primary characteristics, says Jon Michael Vore, DO, chief medical information officer Southern New Hampshire Health. The Nashua, New Hampshire-based health system features a medical center and a network of more than 400 clinicians.
First, a clinical decision support tool must be easily accessible to clinicians at the point of care, he says. “You want clinical decision support at the point of care when you are taking care of a patient. If you are going to have a clinical decision support tool, it needs to be at your fingertips. If you have to go into a completely separate system or leave the room, it detracts from being able to use a tool. A clinical decision support tool should be directly integrated into your workflow.”
Second, a clinical decision support tool must be as current as possible, Vore says. “A good clinical decision support tool should be up to date and peer reviewed. If you are sharing information with a patient, you want to make sure that you have the most up-to-date recommendations in regards to whatever you are talking about.”
Third, a clinical decision support tool must be accurate, he says. “A good clinical decision support tool is trustworthy. You need to be able to trust the information that the tool is providing. These days, patients are doing their homework and they are checking up on you. When they leave the office, they are not absolutely assuming that the provider has given them 100% correct information. Many times, they are going home and following up and doing their own review and seeing if the information their clinician has provided is accurate.”
Clinical decision support tool in practice
Southern New Hampshire Health has clinical decision support in the health system’s electronic medical record as well as Wolters Kluwer’s UpToDate clinical decision support tool.
“We have the Epic electronic medical record system. There are a lot of clinical decision support tools in Epic, where you get best practice advisories. You get medication and allergy interactions as well,” Vore says.
At the health system, UpToDate is integrated into Epic, he says. “As we are doing our documentation or seeing patients, we have a hyperlink directly in Epic that will automatically log a provider into UpToDate and allow them to do a search for medical conditions. This allows providers to have a clinical decision support tool at their fingertips. Providers do not need to go to another Web browser or type in a URL. Having UpToDate integrated into our electronic medical record makes it quick and easy for clinicians to access information they need to verify their treatment or even review information with the patient in the exam room.”
Using clinical decision support tools to address misinformation
A good clinical decision support tool can help clinicians to educate misinformed patients, Vore says. “If you know you have a trustworthy source of information that has the most up-to-date recommendations and the most up-to-date information from studies, that arms clinicians to have sometimes difficult conversations with patients. These days, patients will go to the Internet, go to blog sites, and go to social media such as Facebook. They often do not go to the most evidence-based resources to look for information.”
A good clinical decision support tool will approach areas where there is information that needs to be debunked, he says. “Many times, these tools will present information in a way that can be easily transferred to the patients. That may or may not change the outcome with the patient, but the best that clinicians can do is provide them with the most up-to-date information and recommendations to help them move in an appropriate direction for their overall health.”
Christopher Cheney is the senior clinical care editor at HealthLeaders.