KLAS: CDS tools need to integrate into physician workflow
Clinical decision support (CDS) tools are starting to have a real impact on healthcare providers, but still have some kinks to work out, according to a new report from KLAS.
The researchers looked at hospitals' use of several kinds of CDS solutions, including care plans, diagnostic decision support, disease reference, drug databases, order sets and surveillance software. Most respondents were unable to quantify the clinical outcomes that resulted from using these applications. Still, they indicated that some solutions--such as those for order sets and care plans--made it easier standardize care processes. Fully adopted order sets, disease/drug reference tools and surveillance tools--used for early identification of patients who have developed complications--had the highest impact on clinical decision making.
The biggest problem with all of those tools, the report says, is their lack of integration into EMRs/EHRs and clinical workflow. "CDS content is most effective when in real time, which requires integration into both provider workflow and EMR systems," the report's authors write. "Some CDS tools are further ahead with EMR integration than others, though most struggle. That said, EMR integration--though key--is not the golden ticket. For CDS tools to be fully effective, they need to integrate into the clinician workflow, which is much more challenging."
One of the challenges in adapting CDS to clinical workflow lies in adjusting their sensitivity to the requirements of frontline care. For example, the hyperactivity of alerts in drug databases may lead to "alert fatigue," the report said.
KLAS surveyed providers about their use of the following solutions:
- Care plans: Elsevier's CPM Resource Center, Zynx Health's ZynxCare
- Diagnostic: Isabel, Logical Images' VisualDx
- Drug Databases: Cerner's Multum, First DataBank, Wolters Kluwer's Medi-Span
- Disease Reference: EBSCO's DynaMed, Elsevier's MDConsult/First Consult, Wolters Kluwer's UpToDate
- Drug Reference: Thomson Reuters' Micromedix, Wolters Kluwer's Lexicomp Online
- Order sets: Wolters Kluwer's ProVation Order Sets, Zynx Health's ZynxOrder
- Surveillance: Thomson Reuters' Clinical Xpert CareFocus, Wolters Kluwer's Pharmacy OneSource's Sentri7