February: The month of love and home of the much commercialized Valentine's Day. More recently, this month has been affiliated with an increased focus on heart health. The opportunity to review the positive impact that clinical decision support systems can make on cardiovascular disease prevention and control seemed very relevant to me.
Clinical decision support systems (CDSS) are computer-based information systems that assist in providing clinical guidance to providers at point of care. Based on specific patient data entered manually or integrated with an electronic medical record system, CDSS recommendations reflect clinical assessments and evidence-based treatment protocols. CDSS are often linked with knowledge management solutions that provide the most up-to-date scientific literature for providers.
The Community Preventive Services Task Force (an independent non-federal panel of public health and prevention experts established by the U.S. Department of Health and Human Services) recently posted recommendations on their website regarding the impact of CDSS on improvements in cardiovascular disease prevention and control.
The cardiovascular disease (CVD) CDSS typically include one or more of the following interventions:
- Reminders of overdue preventive care for CVD
- Patient risk assessments for CVD development
- Evidence-based treatment recommendations for CVD prevention
- Recommendations for behavioral health changes for CVD prevention
- Alerts as indicators when risk factors are not at goal
The task force reviewed evidence from 45 studies, analyzing the effectiveness of CDSS on CVD . Based on their extensive review, recommendations from the task force support CDSS – finding sufficient evidence of moderate quality-of-care outcomes for CVD prevention, indeterminate evidence for risk factor measurement, and an overall greater potential for improvement with CDSS involvement.
While most of the studies reviewed the role of CDSS in CVD prevention solely, several also incorporated CDSS as a tool within a multi-faceted approach to overcome obstacles at various levels within the healthcare system.
The benefits of a successful CDSS include:
- Automated provision of assessments and treatment recommendations at point of care
- Integration into daily workflow of charting and order entry
- Provision of research based support of decisions
- Promotion of action rather than inaction
Technology has taken on a more active role in today's healthcare. In addition to electronic health records and surveillance systems, CDSS can be a formidable tool as an agent of change for quality of care and patient outcomes within CVD and other disease states. The time is right for providers to embrace and accept technology into their practice.