INCORPORATING EVIDENCE:USE OF COMPUTER-
BASED CLINICAL DECISION SUPPORT SYSTEMS
FOR HEALTH PROFESSIONALS
DEFINITION
• CDSS
• ARE AUTOMATED TOOLS DESIGNED TO
SUPPORT DECISION-MAKING ACTIVITIES AND
• IMPROVE THE DECISION-MAKING PROCESS
AND DECISION OUTCOMES.
• ANY COMPUTER POGRAM THAT HELPS
HEALTH PROFESSIONALS MAKE CLINICAL
DECISIONS.
TYPES
• ADMINISTRATIVE AND ORGANIZATIONAL
SYSTEMS
• INTEGRATED SYSTEMS
CHARACTERISTICS
• CAN BE STUDIED BASED ON THEIR
STRUCTURE, ORGANIZATION, CONTENT OR
THEIR PURPOSE.
KEY CDSS FUNCTIONS
• ADMINISTRATIVE- supports for clinical coding
and documentation
• MANAGEMENT OF CLINICAL COMPLEXITY AND
DETAILS-keeping patients on research and
chemotherapy protocols, tracking orders,
referrals, follow-up and preventive care
• COST CONTROL-monitoring medication orders
and avoiding duplicate or unnecessary tests
KEY CDSS FUNCTIONS
DECISION SUPPORT-supporting clinical
diagnostic and treatment plan processes
promotion of best practices, use of condition-
specific guidelines, and population-based
management.
Examples of CDSS Applications
• Page 172
CDSS IMPACT ON CLINICIANS AND CLINICAL
DECISIONS
• IMPROVED QUALITY OF CARE
• LESSSEN THE INCIDENCE OF ADVERSE DRUG EVENTS,
NOSOCOMIAL INFECTIONS AND INAPPROPRIATE USE OF
ANTIBIOTICS
• PREVENTS PRESCRIPTION ERRORS
• EFFECTIVE CLINICAL DECISION SUPPORT DEPENDS ON CDSS SPEED
• ANTICIPATION OF INFORMATION NEEDS
• REAL-TIME DELIVERY
• USABILITY
• SIMPLICITY
• MAINTENANCE OF KNOWLEDGE-BASED SYSTEM
BARRIERS TO THE USE OF CDSS SYSTEMS
• LACK OF NOTICEABLE BENEFITS
• INSUFFICIENT COST BENEFITS
• INADEQUATE STAFF TRAINING
• LACK OF SYSTEM SUPPORT
5 ELEMENTS TO EVALUATE CDSS
• 1. INTEGRATED REAL-TIME PATIENT DATA BASE
• 2. DATA-DRIVE MECHANISM
• 3. KNOWLEDGE ENGINEER
• 4. TIME-DRIVEN MECHANISM
• 5. LONG-TERM CLINICAL DATA REPOSITORY
• PAGE 175
CTA
• COGNITIVE TASK ANALYSIS?
• IDENTIFY THE 6 STEPS APPROACH TO CTA
• PAGE 176
IMPLICATIONS FOR FUTURE USES OF CDSS IN
NURSING
quiz
• 1. define in 2 sentences CDSS
• 2. differentiate in 3 sentences the types of
CDSS.
• 3. Enumerate the key functions of CDSS
• 4. Enumerate 4 barriers to the use of CDSS