Posts Tagged ‘Clinical Decision Support’
December 14, 2012
One of the most powerful concepts in changing healthcare is the Learning Healthcare System explained in most detail in this Institute of Medicine report. The concept of using evidence from research to rapidly into practice in a virtuous cycle. But how exactly to operationalize this concept?
Two recent examples are beginning to move along this path in utilizing data to develop customized order sets. One is IBM Watson working with Memorial Sloan Kettering Cancer Center. Using its powerful natural language processing (NLP), Watson is able to match patient data including complex genomics with the wide array of order sets available for different types of cancer. ” The medical center has about 2,000 order sets it can pull from when choosing a cancer treatment.” And data on millions of patients. Finding patterns that match requires the speed and logic of the Watson engine.
A second example uses existing medical knowledge and updates it as published and then converts these into order sets for a procedure-based EMR system. With their combination of the knowledge of current practices in tools like Up-To-Date and an EMR called Provation, they are now combining these products to enable the regular updating of order sets in the EMR including integration with comprehensive EMRs. This demonstrates the last mile of clinical decision support and evidence-based medicine. Bringing the latest discoveries to EMR order sets through an integrated solutions.
Looking forward to more solutions that fulfill the vision of the Learning Healthcare System.Share this:
January 25, 2011
In a new study in the Archives of Internal Medicine, the hypothesis that electronic medical records would improve quality was not borne out. However, what was not picked up by most news stories about the article was that the data was from 2005-2007, 4 years old during a period of rapid adoption of EMRs. An accompanying editorial titled “Clinical Decision Support and Rich Clinical Repositories: A Symbiotic Relationship“, is critical of the report stating, “This lack of effect of CDS [clinical decision support] on provider behavior was surprising given the strong effects previously reported in randomized controlled trials of these systems.” These critics note that most of the guidelines which are more likely to be followed are immunizations rather than medication use which the study focused on. In conclusion, the editorial writers from the National Library of Medicine state, “Only when EHRs carry rich repositories can we expect EHRs to reach their promise and CDS to have measurable effects on a broad range of quality measures at the national level.”
My conclusion is that the use of clinical decision support within EMRs can impact quality on a national level but that early implementation of EMRs may take time to demonstrate this impact.Share this: