Clinical Decision Support Systems by Eta S. Berner

Author:Eta S. Berner
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

No need for additional clinician data entry,

Promotion of action rather than inaction,

Justification of decision support via provision of research evidence,

Local user involvement in the development process, and

Provision of decision support results to patients as well as providers [5].

Lobach et al. noted that many of the evaluation studies included CDSS with more than one feature, and thus it was difficult to determine the importance or impact of any one individual feature [5].

A more extensive systematic review reporting on 148 CDSS evaluation studies was published by Roshanov et al. [11] This review found that CDSS were associated with success when (1) the system was developed by the authors of the study, (2) the system provided advice to both patients and clinicians, and (3) the system required a reason for overriding advice. Roshanov et al. also found that “advice presented in electronic charting or order entry systems showed a strong negative association with success” [11]. In contrast to the findings reported by Kawamoto et al. [10], Roshanov et al. found that neither advice automatically provided in workflow nor advice provided at the time of care were associated with successful CDSS [11].

To date, efforts to identify the most critical features associated with successful CDSS have been inconclusive in that the largest studies have reported conflicting results. The findings do imply that features that integrate CDSS into existing workflows and justify the CDSS recommendations lead to greater success; however, more evaluations deliberately focusing on the impact of specific CDSS features are needed.

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