Clinical decision support

Clinical decision support tools support health care providers at the point of care by presenting relevant information at the appropriate time.

These tools do not make decisions for you; they allow you to make fully-informed diagnoses and decisions, using your experience, expertise and observations.

“CST is not going to dictate absolute practice to care providers,” asserts Dr. Kellé Payne, former CST Executive Director and Transformation Lead, VCH. “Health care providers can continue to make appropriate decisions for patients, but these will be strengthened by the shared knowledge of highly skilled health care professionals based on recommendations from industry-standard, quality-of-care research.”

Clinical decision support tools include:

  • reminders for preventive care;
  • alerts about potentially dangerous situations;
  • evidence-based clinical guidelines;
  • condition-specific order sets;
  • and more.

“For example,” says Kellé, “a patient arrives in the Emergency Department profoundly confused, and is identified by her driver’s licence. The system brings up an alert based on this identification – she is highly allergic to latex, so using such products could endanger her. The team would know that right away and make appropriate decisions based on that knowledge, without her having to verbalize it.

“Reminders about medications are also very important. A consultant orders a medication and the system reminds her that the patient has already had the maximum dose of that drug for the day. It will also remind her about any interactions with medications the patient takes at home.”

Bradley Ho, Clinical Informatics Lead, Pharmacy/Medication Safety, says one of the Medication Management Team's biggest achievements is building clinical decision support tools for use when a provider is placing medication orders and a pharmacist is verifying those orders.

“These tools include allergy and drug interaction checking, dose range checking on high-risk medications and alerts when drugs excreted through the kidneys are ordered for renally-impaired patients,” explains Bradley. “Without computerized provider order entry (CPOE), this would not be possible.”

“You can use reminders to make sure you don’t miss important treatment decisions,” adds Kellé. “If an elderly patient has broken his shoulder and the arm needs to be immobilized, it is easy to forget that he still needs to be walked regularly. The system can even remind you that he normally walks with a cane.”

Why use clinical decision support tools?

  • Patients receive better care based on better information.
  • Patient outcomes improve because we can provide the most appropriate care.
  • Fewer medical errors and adverse events occur.
  • Improved efficiency can lower costs and increase patient satisfaction – for example, clinicians are alerted if a duplicate test is ordered, which if completed would incur a cost and potentially inconvenience the patient.

“This is not about trying to create cookie-cutter care,” Kellé emphasizes. “For me, appropriate high-quality clinical decisions always come first in the case of any patient. Business decisions and processes come second, and technology third. However, we must all work hand-in-glove to make patient care as effective and as safe as possible.”

You can download a printable version of the article Clinical decision support in the CST system: the benefits (PDF).