Wednesday, May 08, 2013

It Looks Like People Are Starting To Get Realistic With Clinical Decision Support - A Good Thing.

This appeared a little while ago.

Benchmarks: Changes are afoot for clinical and business intelligence

By Mike Miliard, Managing Editor
Created 04/22/2013
A study earlier this year from the University of Missouri showed that most patients took a dim view of doctors who make use of clinical decision support technology.
Researchers found that patients saw physicians who use CDS as somehow less capable than those who don't. They saw the IT tools as impersonal, and thought the systems were a barrier between them and their caregivers.
That's the wrong way to think about it, says John Hoyt, executive vice president, HIMSS Analytics.
"They just need to understand it's not taking the place of their physician," he says. "It's an aid and reminder of the latest peer-reviewed advice and best practice alerts, etc."
It can "touchy," says Hoyt, because it may suggest, "subconsciously, that your physician is flawed, that he has a human brain – that may be a shock to some people."
But far from being a cheat, or a crutch to be leaned upon, decision support is an essential tool in the clinician's arsenal. Especially nowadays.
"Things get complex," he says. "A good physician will go out and search the literature. In days of old, they used to spend time in the medical library. But now we can bring it to their faces, at the moment."
But there's a fine line between that and "in your face," as it were.
Designing CDS to supply relevant information – at the right time and place – without risking physician alert fatigue, "is an art," said Hoyt. "We don't want to remind the physician, 'Hey, we've got a patient with high cholesterol, order a lipid test.' For God's sake, they know that."
It's even worse in the pharmacy: "Every minute, today, in these hospitals, the pharmacists are getting alerts that are far more detailed and hypnotic than the physicians get."
But clinical and business intelligence technology is changing, evolving – and getting smarter.
"Now that we've had electronic medical records for years, we have data," says Hoyt. "And we now can do some real analysis of our practice patterns and our outcomes. This is now mega data analytics. But eventually you can bring it to the bedside as well: 'From our experience, here at Acme Hospital, we have learned that . . . ’ And you can no deliver that content to the physicians at the bedside."
For the most part, most decision support content is still purchased from sources like Zynx Health and Milliman, he says. But lately, bit by bit, "organizations that are doing their data analytics are seeing their practice patterns" – seeing what works and what doesn't – "and they're able to deliver that data to the bedside."
Recently, HIMSS Analytics has been publishing a series of white papers examining how different hospitals and health networks have been designing and deploying their own clinical and business intelligence programs in the pursuit of value-based care.
And this past month it was announced at the 2013 HIMSS Annual Conference & Exhibition that HIMSS Analytics is partnering with The International Institute for Analytics to develop a model that's meant to help more providers do the same.
Billed as the first benchmarking survey designed to measure and score clinical and business intelligence and analytics maturity in healthcare organizations, the project – to be launched in May – will offer health organizations an unbiased assessment of their program’s maturity compared to their peers.
"The model helps organizations transition from the acquisition of clinical and business intelligence tools to the implementation and use of those tools in an effective way," says James Gaston, senior director of clinical & business intelligence at HIMSS Analytics, who's spearheading the project.
Heaps more here:
I have to say I thought the study cited in the first few paragraphs was just rubbish. Any clinician, in these days of extreme information overload, who does not fall on practical help with glad cries is, I would suggest both pretty arrogant and also pretty ignorant!
In my many years of practicing in intensive care medicine I was happy - no keen - to take advantage of any help I could get. The old saying two heads are better than one is true in my view - even if one is a smart computer.


Paul Fitzgerald said...

I think that the old days of denial of CDS as "cook book medicine" are gone, thankfully and clinicians are starting to see the benefits. Part of this is the progress of the tools themselves. Predictive analysis is the next frontier - where we can now predict a patient heading south several hours ahead of it happening - if this migrated to the home, and monitored by a Vital Call or similar, we may just get people out of the hospitals and back home sooner, and also prolong their lives.

Terry Hannan said...

David, when I initially read your intro into this piece I thought this may be a positive. I am glad your extended notes called it rubbish because that is what it is (from my perspective). Also reading your analysis and Paul Fitzgerald's comment it reminded me of Alan Pryor's (HELP, form LDS Utah)statement when discussing Artifical Intelligence. He replied, "we don't need AI all we need is commonsense in our DCS tools". Terry