Clinical Decision Support

Clinical decision support (CDS) provides timely information, usually at the point of care, to help inform decisions about a patient's care. CDS tools and systems help clinical teams by taking over some routine tasks, warning of potential problems, or providing suggestions for the clinical team and patient to consider.

Why Is Clinical Decision Support Important?

The main purpose of CDS is to provide timely information to clinicians, patients, and others to inform decisions about health care. Examples of CDS tools include order sets created for particular conditions or types of patients, recommendations, and databases that can provide information relevant to particular patients, reminders for preventive care, and alerts about potentially dangerous situations. CDS can potentially lower costs, improve efficiency, and reduce patient inconvenience. In fact, CDS can sometimes address all three of these areas at the same time—for example, by alerting clinicians about possible duplicate tests a patient may be about to receive.

How Can Clinical Decision Support Be Put Into Action?

CDS can be used on a variety of platforms (such as the Internet, personal computers, electronic medical record networks, handheld devices, or written materials). Planning for a new health information technology (IT) system to support electronically-based CDS includes a number of key steps, such as identifying the needs of users and what the system is expected to do, deciding whether to purchase a commercial system or build the system, designing the system for a clinic's specific needs, planning the implementation process, and determining how to evaluate how well the system has addressed the identified needs. In the case of CDS, issues around design and implementation of the system are often interconnected.

AHRQ's CDS Initiative includes a variety of research projects and outreach efforts to develop agreement in the health care field around the use of CDS to promote safe and effective health care. Each part of the initiative attempts to engage clinicians, provider organizations, guideline and quality measurement developers, and IT professionals in the ongoing work to improve making health care decisions using CDS systems.

Other resources include:

• Health Assessments in Primary Care: A How-to Guide for Clinicians and Staff
• A Roadmap for National Action on Clinical Decision Support
• Structuring Care Recommendations for Clinical Decision Support
• Challenges and Barriers to Clinical Decision Support Implementation
• Clinical Decision Support Systems: State of the Art
• Community Connections: Linking Primary Care Patients to Local Resources for Better Management of Obesity

The following AHRQ Annual Conference presentations on clinical decision support are also available:

Use of Clinical Decision Support Tools to Facilitate Evidence-Based Patient Care – 2010

• The Cancer in the Family Clinical Decision Support Tool (
   Microsoft PowerPoint version - 3.72 MB
  )
  
  Linda Squiers, RTI International

Structuring Clinical Recommendations for Clinical Decision Support – 2010

• Structuring Care Recommendations for Clinical Decision Support (
   Microsoft PowerPoint version - 3.54 MB
  )
  
  Jerry Osheroff, Thomson Reuters

Clinical Decision Support Tools for Ambulatory Settings – 2008

• Clinical Decision Support Consortium (
   Microsoft PowerPoint version - 2.16 MB
  )
  
  Blackford Middleton, Harvard Medical School

Value of Clinical Decision Support – 2007

• Influencing Patient Safety in Rural Primary Care Clinics Through Computerized Order Entry
  
  Matthew Samore, VA Salt Lake City Health Care Systems/ University of Utah
• Effective Decision Support: Lessons Learned in Community-Oriented Care
  
  David Lobach, Duke University School of Medicine