Jonathan Teich, MD, an emergency physician and internist, expects meaningful use requirements to give clinical decision support a boost.

Teich, who serves as chief medical informatics officer at Elsevier, one of several companies that have CDS offerings, explained the juncture of meaningful use and CDS this way in a recent video produced by Elsevier.

“I know that as a practicing physician that I’m going to be expected to have medications online that I can see, that I’m going to be expected that I can check those medications and make sure that both the dosing and their relations to the patients other parameters are correct. I know that I’m going to be expected to have information readily available about whether I’m following quality measures appropriately and that as the situation comes up, I’m going to be expected to know that a situation exists. If I’m taking care of a diabetic, I may not remember all the particular quality goals of a diabetic, but I’m expected to have a system that helps me remem- ber them, helps me follow them. So I know that the information system is going to become more than just a passive recorder of fact. It’s going to become some kind of active partner. In some ways it’s going to become not so much an active consultant, but it’s going to become a very conscientious helper that makes sure that I’m keeping track of the things that I should be keeping track of."

The Healthcare Information Management and Systems Society, too, says CDS comes into play with meaningful use requirements in three ways:

1. For Clinical Outcome Measures: (e.g. rates for VTE prophy- laxis, cancer screening) CDS can facilitate performance improve- ment; deploying CDS effectively is key to realizing potential CDS value and optimizing cost/benefit of CDS effort

2. For CDS-related Objectives: (e.g. drug safety/formulary checks, CDS rules) it is critical to follow best CDS implementation prac- tices to avoid common problems such as alert fatigue and clinician frustration that interfere with quality/safety goals.

3. For other technology and record deployment objectives/mea- sures: (e.g. CPOE use, med lists) thoughtfully addressing CDS-related components (e.g. relevant data presentation, order sets, documen- tation tools for CPOE) can help ensure that HIT value is realized.

Three Pillars of CDS

These three pillars of CDS are offered by the American Medical Informatics Association in “A Roadmap for National Action on Clinical Decision Support,”

1. available: Make the best knowledge readily available when it is needed – actions include building highly practical formats and services for representing, collecting, organizing, and distributing clinical knowledge and CDS interventions.

2. adoption: Foster increased adoption and effective use – actions include organizing and publishing best strategies for improving CDS system design, usability, and implementation, as well as strategies for addressing legal and financial barriers.

3. improve: AContinuously improve CDS interventions and health-related knowledge – actions include developing system- atic methods for sharing CDS experience and for leveraging electronic health records to enhance clinical knowledge

Market aligns for surge in CDS

Activehealth
CareEngine
The patented technology compiles member data from a variety of sources such as medical and pharmacy claims, lab results and information provided directly from the member. The CareEngine analyzes this information against highly respected sources of evidence- based medicine to identify gaps in care, medical errors and quality issues.

Amisys
STATck
Amisys is a medical information systems provider that develops its own proprietary technology and content exclusively in the image-intensive areas of medicine and surgery. Amisys says its founders and its 150+ member author and contributor team is a “who’s who” of practice areas of radiology, pathology, surgery and other specialty fields.

EBSCO
Dynamed
Within a healthcare provider setting, EBSCO provides medical information anywhere and anytime - from the patient’s bedside to the PDA to the library.

Elsevier
Clinical Decision Support
Elsevier Clinical Decision Support delivers accurate, evidence-based and actionable information whenever and wherever needed within the healthcare workflow. From concise answers to in-depth information to real-time data analysis, Elsevier provides it.

Lexi-Comp
Lexi-Data
Lexi-Comp, Inc. creates trusted, clinically- relevant reference content to provide point-of- care decision support in key areas, including pharmacology, drug interactions, and laboratory tests and diagnostic procedures. The information is available for PDAs, online, through local Intranet servers, and as Web- based datasets.

Medworxx
Clinical Utilization Management
Medworxx makes a strategic software platform that hospitals use to communicate, aggregate, and analyze knowledge. Medworxx customers leverage the power of knowledge to increase competency, reduce redundancy, reduce costs, and simplify distribution of knowledge to staff and patients.

Perioptimum
Surgical Capacity Improvement Program
PeriOptimum hospital and surgicenter clients increase surgical throughput (more cases in prime shift), according to the company. The surgical capacity evaluation and improvement programs all result in greater surgical throughput.

Thomson Reuters
Clinical Xpert Medication Reconciliation
The Healthcare & Science business of Thomson Reuters produces insights, information, benchmarks and analysis that enable organizations to manage costs, improve performance and enhance the quality of healthcare.

Wairever
Plexina
Wairever is a full service healthcare information technology company offering software, services and support to meet any healthcare provider’s clinical content and resource scheduling needs. Plexina 2.0 is a revolutionary clinical content management software platform that optimizes the development, management and integration of evidenced-based” and standardized practice.

Wellogic
Wellogiic Consult
Wellogic Consult, the company’s award- winning clinical solution, unifies patient information and clinical workflows across hospital, payer, employer, pharmacy, and service provider systems, providing clinical decision support and allowing the creation of longitudinal patient records over time. Consult offers solutions for community-based health information exchanges (HIEs), clinician and patient portals, EHRs, e-prescribing, document management, CPOE, referrals and second opinions, secure messaging, and more. It provides anytime, anywhere access for browsing results, reviewing alerts, creating orders, documenting findings, checking schedules, communicating with colleagues and patients, and reviewing literature, all within a secure Web environment.

Zynx
ZynxCare
Zynx Health, a subsidiary of The Hearst Corporation, offers evidence-based clinical decision support technology. The Zynx team of physicians, nurses, and allied health professionals rigorously review the latest peer-reviewed literature to develop clinical summaries and distill evidence-based best practices. Evidence is made actionable in multiple forms including order sets, interdisciplinary plans of care, alerts, and reminders. Zynx Health’s two flagship products are ZynxOrder and ZynxCare. ZynxOrder is an advanced knowledge management system for developing and maintaining evidence-based order sets, alerts, and reminders. ZynxCare offers evidence-based plans of care for nurses and the interdisciplinary care team.