2 lingering misconceptions around clinical decision support

Although clinical decision support systems date back to the 1980s, the tool still faces misconceptions about implementation and value. 

A large body of evidence over many years suggests that real-time clinical decision support systems integrated into clinician workflow can be helpful in adherence to evidence-based guidelines and improve the quality, safety, efficiency and effectiveness of care. 

Nonetheless, real-time clinical decision support is a sophisticated component of health IT. To learn about the misapprehensions clinicians and health system leaders may have about clinical decision support systems, Becker's Hospital Review caught up with Scott Weingarten, MD, consultant to the CEO, professor of medicine and member of the medical staff at Cedars-Sinai and chief clinical and innovation officer with Premier, during the Becker's Clinical Leadership Virtual Event.

The idea that clinical decision support is synonymous with more alerts is one common misconception about the technology. "Alerts are one arrow in the quiver," said Dr. Weingarten. Clinical decision support also involves guidelines, pathways, modifications to order sets and preference lists and peer comparison feedback so healthcare providers can assess their practice in comparison to their colleagues. Dr. Weingarten also points out that when clinical decision support alerts bring value to patient care, they are less likely to be perceived as fatiguing or burdensome. "When providers find it valuable, helpful, they rarely find it fatiguing," he said. 

Another common misconception about clinical decision support is that it's a silver bullet. In fact, adding clinical decision support to existing workflows does not mean care will improve or change. The right processes, incentives and ecosystem have to be in place first. "You have to think about the environment upon which you're dropping the clinical decision support into," said Dr. Weingarten. "For example, what are the incentives? Are the incentives aligned with the intent of the clinical decisions or are there overwhelming countervailing incentives that would potentially prevent the clinical decision support from changing care?"

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