Clinical Decision Support Flashcards
What is Clinical Decision support
two or more items of patient data to generate case specific advice
What determines CDS targets
Desired outcome (efficiency, detection, screening, diagnosis)
Target audience (healthcare person, patient, family)
Level of control (pre-emptive, suppressible, interruptive)
Modal vs modeless
in line or pop-up/interruptive
effective CDS
- speed (latency)
- anticipate needs and deliver in real time
- Fit into workflow
- usability
- dont tell docs to not do something without an alternative
- changing direction is easier than stopping
- Simple interventions work best
- Ask for additional info only if it is needed (more extra data elements, less likely to be successful)
- Monitor impact, get feedback
- Manage and maintain your knowledge based systems
5 rights of CDS
- right information
- right person targeted
- right format - usability
- Right channel- mode of cds
- Right time (workflow integration)
curly braces problem
local data calls are difficult–differing data environments and data source systems
HL7 FHIR
RESTful syntax designed for ease by developers (common web commands)
strategies to mitigate alert fatigue
- Alerts classified to three levels
- Develop a core set of critical drug-drug interactions
- Classify alerts into active and passive
Critical alerts should be active and interruptive - Conduct training on new improvements
- Develop systems with automated feedback/learning to identify and move alerts from active/interruptive to passive/non-interruptive
Context- orders in a sedation suite vs inpatient floor for benzos +narcs
Pragmatic ambiguity
conflicting recommendations within a guideline
Semantic ambiguity
insufficient detail
Syntactic ambiguity
language that prevents translation into a machine-interpretable condition or syntax.
Conditional ambiguity
component of a condition is insufficiently detailed
Boolean operators
and ….. or
on demand cds alert
Fries only when the user requests it
