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Clinical Decision Support System – At A Glance

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CDSS, according to Eta S. Berner and Tonya J. La Lande, is a computer system designed to influence physician decision making about individual patients at the time the decision was made (Eta S. Berner, 2007). CDSS can also be interpreted as an interactive decision support system, and utilize clinical data related to the patient. While the decision support system (DSS = Decision Support System) in the health care information systems usually support a retrospective analysis of finance and administration. Excellence CDSS use, including:

  • Improving patient safety by reducing medication errors and adverse events that are not necessary, and reduce errors unnecessary tests,
  • Improving the quality of health services, improving the implementation of clinical pathways and evidence-based clinical practice guidelines, and facilitates the use of scientific evidence supporting the best in service to patients, and
  • Improve efficiency in health care, by reducing unnecessary costs, reduce duplication of tests, as well as reducing variation and waste prescription.

There are two categories of CDSS. They are knowledge based and non-knowledge based. Non-knowledge based uses a form of artificial intelligence called machine learning, which allows the computer to learn from past experience and / or find patterns in clinical data. While knowledge based using the knowledge base in support of its performance. In analysis of the CDSS development, Bates, et al suggested 10 conditions that must be applied in this field (David W. Bates, et al., 2003), as follows:

  1. Speed is everything
  2. Anticipate needs and deliver in a real time
  3. Fit into the user’s workflow
  4. Little things can make a big difference
  5. Recognize that physician will strongly resist stopping
  6. Changing direction is easier than stopping
  7. Simple interventions work best
  8. Ask for additional information only when you really need it
  9. Monitor impact, get feedback and respond
  10. Manage and maintain your knowledge based systems

Refference:

  1. Berner, Eta. 2007. Clinical Decision Support Systems : Theory and Practice, Second Edition. Springer Science + Business Media: New York.
  2. W. Bates, David, et al. Ten Commandments for Effective Clinical Decision Support: Making the Practice of Evidence-based Medicine a Reality. J Am Med Inform Assoc. 2003;10:523–530.