Best Practices in Clinical Decision Support: the Case of Preventive Care Reminders.

BACKGROUND: Evidence demonstrates that clinical decision support (CDS) is a powerful tool for improving healthcare quality and ensuring patient safety. However, implementing and maintaining effective decision support interventions presents multiple technical and organizational challenges. PURPOSE: To identify best practices for CDS, using the domain of preventive care reminders as an example.

Clinical decision support to avoid adverse drug events with anticoagulants.

Unintentional duplication or timing of anticoagulant orders leaves patients at high risk for serious adverse events. Alerts at the point of electronic order entry have the potential to mitigate this risk; however poor specificity with a high frequency of interruptions may decrease the ability of a clinician to recognize specific hazards. This poster will depict custom clinical decision support designed to prevent specific misadventures with this high risk class of medications.

Viewpoint: controversies surrounding use of order sets for clinical decision support in computerized provider order entry.

Order sets provide straightforward clinical decision support within computerized provider order entry systems. They make "the right thing" easier to do because they are much faster than writing single orders; they deliver real-time, evidence-based prompts; they are easy to update; and they support coverage of multiple patient problems through linkages among order sets. This viewpoint paper discusses controversies surrounding use of order sets--advantages and pitfalls, decision-making criteria, and organizational considerations, including suggestions for vendors.