Recapping a recent response to a great post from Tim Richardson on implementation of Clinical Decision Support Systems:
There is good evidence to show that Clinical Decision Support can be beneficial, such as this study from the British Medical Journal The article points out that one of the more important features of a useful system is that it provide decision support as a normal part of the workflow.
The primary problems with these systems seem to be in two areas:
- “Alert Fatigue” or “The Boy Who Cried Wolf” problem: In many current implementations, the Clinical Decision Support System in the EMR provides so many irrelevant alerts that that the useful alerts are ignored. This is especially true with systems that alert physicians about drug interactions. (Imagine getting 2 or 3 separate pop up warnings on your computer screen every time you attempted to write a prescription.)
- Clinical decision support systems are not a substitute for a brain. These systems fail miserably when implemented as if they could replace, rather than supplement, training, experience, and wisdom. A well designed system should provide intuitive, non-obtrusive guidelines, not true decsion making.
I would love your comments.