Describe the approaches you would use to ensure that all aspects of patient care were considered when developing a CDS system.

Imagine that you have been appointed as director of clinical decision support at a healthcare delivery system. This healthcare system consists of several large hospitals and multiple outpatient clinics and uses the same EHR system across the enterprise.

There has been limited CDS activity at the institution prior to your arrival. Now, with Meaningful Use and the increasing need to provide increased care value, the appropriate use of CDS is an institutional priority. The current CDS available at your institution consists primarily of off-the-shelf drug interaction and drug–allergy alerting, which is the source of significant clinician complaints due to the rate of false-positive alerts.

There is a strong sense within the institution’s administration that IT in general and CDS specifically should be leveraged to improve care value and to enable the institution to influence its clinical practice patterns more systematically and more rapidly. You have a reasonable budget and adequate staff to make meaningful changes. You also have support from key institutional stakeholders, including healthcare system executives, the nursing informatics officer, and the chief medical informatics officer. You have been asked to devise a strategic plan for CDS at your institution within 3 months of your arrival and to have concrete “wins” within.

In your response, please include the following information:

Describe the approaches you would use to ensure that all aspects of patient care were considered when developing a CDS system. How would you prioritize the efforts of your CDS team?
Potential areas on which to focus include areas in which payment rates are tied to national quality measures, CDS interventions that meet Meaningful Use requirements, readmissions for congestive heart failure and other care events for which payers increasingly are not reimbursing, and areas that have been identified as institutional priorities for clinical improvement.


 

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