Electronic Health Reporter

Guest post by William Daniel, M.D., medical director of Quality at Mid-America Heart Institute, Kansas City, and Chief Medical Officer for Emerge CDS.

With the new wave of healthcare reform upon us, hospitals are seeking ways to meet requirements of . With a growing number of hospitals incorporating electronic health records, health IT tools are becoming more prevalent. In fact in August 2012, a second stage of meaningful use guidelines for EHRs was set requiring physicians to use some form of clinical decision support in their practice.

The purpose of clinical decision software (CDS) software is to help the doctor?patient work process run more smoothly, however, often times, hospital staffs complain about technologies adding more time and money to the work flow. In a CompTIA’s study, 56 percent of respondents noted a need to make health IT tools easier to use, improve interoperability and increase operating speed.

As a doctor who has used many health IT tools, and engineered my own CDS software, I have compiled seven important features that make CDS software effective.

Ease of use — It doesn’t matter how beneficial the product potentially is, if it’s not easy to use, doctors won’t use it. Doctors are under more pressure to make appropriate clinical decisions and document those decisions in an efficient manner even when allowed less time for each patient. A recent study showed that 75 percent of healthcare HR professionals feel that implementing new health technologies will increase their administrative burden and costs. Software must fit seamlessly into the workflow and provide the most important information in a clear and concise manner without adding extra steps for the doctor and clinical staff.

Customization — CDS software needs to be flexible so that it can be adjusted to fit the particular needs and workflow of the individual healthcare provider, practice or hospital. Different groups have different preferences, expertise or standardized questions for determining diagnosis and treatment. Software needs to account for all possibilities and must be able to be incorporated in to a variety of workflows.

Use a Cloud Server — Health IT software should be hosted on a cloud server. When data is stored on the cloud, it can be accessed anywhere and instantly updated. This is more effective to practices because they do not have to purchase any additional hardware to run the CDS, and because the software company is not on the practice’s IT system it does not tie up bandwidth or capacity of the existing system.

Provide Feedback — In addition to offering decision support, a system should offer feedback reports. It should analyze individual physicians to see if they met AUC, and allow each physician to see the data.  This will set baseline measurements and allow for quality improvements. If the system identifies a large number of cases for a large group of doctors across geographic regions where the criteria were not met, it may not be a problem with the doctors, but may indicate there is an issue with guidelines or criteria.

Don’t Diagnose — One of the biggest reservations doctors and patients have about CDS software is that they perceive the software to be making the diagnosis taking away from the doctor/patient relationship. Only the doctor can provide the necessary judgment, advice and counseling for shared decision making with patients.  Data should be organized into meaningful and actionable information. It should not simply suggest next steps but allow the provider to act on that information directly from the CDS and insert the orders in to the EHR with one simple click.

Eliminate RBMs — There are many complaints that radiology benefit management takes time out of the treatment process, shifts costs to the practice and slows imaging growth. However, if CDS software documents AUC and electronically shares it with insurers, this could eliminate or streamline the RBM process.

Identify the Need for a Specialist — CDS software should not only identify at-risk patients, but also direct care to the appropriate specialist. The need for a specialist doesn’t always present itself; so having software that creates a directional flow will allow the whole practice to work together to get the right patient to the right doctor.

While there are many ways that CDS software can be improved, there are hospitals that have found success in implementing CDS software into the workflow. Emerge CDS, software that helps cardiologists identify at-risk patients for heart disease, is used at HeartPlace, the oldest and largest cardiovascular group in North Texas.

Emerge runs in the background of EHRs and uses a patented algorithm that has been proven to increase diagnosis accuracy by as much as 300 percent. For HeartPlace, Emerge has closed the gap on the number of patients receiving inappropriate care, delivered better quality care for patients and created higher efficiency saving the hospital and patients time and money.

While there are many features that make CDS software beneficial, these seven points should serve as guidelines for hospitals shopping for effective software. The overall goal of CDS software should be this: To do the right thing, for the right patient, at the right time, every time.