CDS key to health reform

Clinical decision support is emerging as a way for providers to cut costs and improve quality of care during an econmic recession.           

“Clinical decision support is the backbone of an effective electronic medical record implementation,” said Joseph Kvedar, founder and director of the Center for Connected Health. “If cost savings are to be achieved in any reform scenario, health information technology must play a role. Clinical decision support guides clinicians to make evidence-based decisions more often, which leads to higher quality care at a lower cost.”

Although the federal government has not yet completed its final definition of meaningful use, clinical decision support, or CDS, is among the components included in the draft definition.

The draft recommendations call for CDS to be used at the point of care by 2013, providing functionalities such as reminders and alerts.

The policy committee expects to receive a new set of recommendations from its workgroup at its July 16 meeting.

“The core functionality of an EHR comes across to doctors as mainly clerical, focusing on recordkeeping, communication and billing,” said Lynn Feldman, CEO of a CDS platform called SimulConsult. “While these are all important, and everyone likes getting paid on a timely basis, physicians are likely to gauge the meaningful use of EHRs by the extent of the integrated clinical decision support available to help make diagnoses more directly and accurately, choose best therapies and avoid errors such as incorrect use of medications.”

“To doctors, the essence of ‘meaningful use’ of computers in medicine is assistance in care of their patient,” Feldman added.

As John Kenagy, MD,  fellow of the American College of Surgeons, sees it, the stimulus money in the HITECH act should be focused first on changes to the existing system, as interoperability between old technology and new is low.

“The current system struggles to give good decision support. Healthcare IT is not really providing meaningful decision support from the promises being made,” said Kenagy. “Information technology is not giving the promise because new systems are not well integrated with current systems.”

“With the stimulus package coming on the scene, this is a very important area to look at,” he said. “For the systems of the future, we need to be thinking cell phones and other mobile devices, not laptops and centralized systems, and technologies that are really integrated into the care process.”