Decision support systems integrated with EHR/EMRs have been shown to decrease venous thromboembolism events postoperatively compared with routine care.
Using a computerized clinical decision support system (CCDSS) is linked with a significant increase in the proportion of patients with adequately ordered treatment to prevent blood clots, according to a study published online by JAMA Surgery.
The systems are also linked with a significant decrease in the risk of surgical patients developing blood clots.
According to the study authors, healthcare professionals do not adequately stratify risk or provide preventive treatment for venous thromboembolism (VTE) among surgical patients.
But CCDSSs that are integrated with electronic health record/electronic medical record systems (EHR/EMRs) and that use data to present evidence-based knowledge at the individual patient level aim to improve that.
Methodology
Researchers at the New York University School of Medicine conducted a review and meta-analysis of 11 articles to assess the effect CCDSSs on increasing adherence to guidelines for VTE prophylaxis and on decreasing VTE events postoperatively compared with routine care without CCDSSs.
They also reviewed clinical trials and observational studies among surgical patients comparing CCDSSs with VTE risk stratification and assistance in ordering prophylaxis versus routine care without decision support.
The studies included 156,366 individuals (104,241 in the intervention group and 52,125 in the control group).
According to the results of the analysis, the "use of CCDSSs was associated with a significant increase in the rate of appropriate ordering of prophylaxis for VTE (odds ratio, 2.35; 95% CI, 1.78-3.10; P < .001) and a significant decrease in the risk of VTE events (risk ratio, 0.78; 95% CI, 0.72-0.85; P < .001)."
Requirement Coming
"The implementation of a CCDSS into an EHR/EMR, especially with an order autopopulation feature, can significantly improve rates of ordering adequate prophylaxis for VTE and is associated with fewer symptomatic DVT and PE events postoperatively," the authors conclude.
Medical Imaging: Appropriate Use Mandate Coming Into View
The increased use of clinical decision support tools will soon be a requirement for some providers. In 2018, the Protecting Access to Medicare Act will require clinicians to consult CMS-approved clinical decision-support mechanisms to guide them in applying appropriate use criteria when ordering certain advanced imaging procedures.
"We should not ignore the strength of computer science in medicine," the authors of the study write.
"The successful implementation of a CCDSS and physician acceptance depend on further trials that lend support to the efficacy of CCDSSs, their cost utility, their user acceptability, and, most important, their ability to change patient outcomes."
Alexandra Wilson Pecci is an editor for HealthLeaders.
