Imagine that you have been appointed 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 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-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 and you do 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 12 to 18
months.
Given the above scenario, please answer the following questions:
1. 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 are increasingly not reimbursing, and areas that have been
identified as institutional priorities for clinical improvement.
Your response must be at minimum 250 words.
Please remember that you must include one citation from a scholarly
source that is within the last 5 years using APA guidelines.
