This appeared a few days ago andis really germane to the current PCEHR discussion.
Clinical Decision Support Closes Medical EvidenceGap
Bestpractice data is available for most healthcare decisions, but health IT teamsare doing a lousy job of getting it to doctors, says Ascension Healthinformatics chief.
September08, 2011
IfMeaningful Use of electronic health records is ever going to fulfill itspromise of better care at lower cost, clinical decision support (CDS) systemshad better play a central role delivering relevant medical evidence to thepoint of care, according to one veteran informatics physician and patientsafety advocate.
"Theevidence of best treatment, if not the right treatment, is available probably85% of the time," Dr. Jeffrey Rose, VP of clinical excellence andinformatics at St. Louis-based AscensionHealth, tells InformationWeek Healthcare. Unfortunately, informationis not often readily accessible.
Thisopinion runs counter to a widelycited statement by Kaiser Permanente's Dr. David Eddy that just 15% of medicaltreatment is supported by scientific evidence. "That's old andwrong," according to Rose, a former chief medical officer of EHR vendorCerner. "When you do further studies, information is available, it's justnot in the clinical environment."
It'salso been widely cited that it takes 17 yearsfor new medical evidence to find its way into practice. By the time thathappens, the evidence could be outdated. That, according to Rose, issymptomatic of practicing without computer assistance. "The overarchingproblem is that doctors cannot possibly update their knowledge as fast as theevidence changes," Rose said, echoing sentiments that medicalinformatics pioneer Dr. Larry Weed has been expressing for half a century.
That'swhere IT, in the form of CDS, comes in. "It's critical in being able tofill in that gap," Rose said. According to Rose, CDS really has threecomponents, and they are not always used together.
Learn morehere:
There aretwo reasons for raising this right now. The first is to note that in therecently released Finalised PCEHR ConOps that Clinical Decision Support is thevery last on the list of proposed enhancements to the PCEHR System (See Page28).
The secondis to point out that a real evidence based intervention of making currentlyavailable clinical literature available via a Government Sponsored Portal - asmentioned in the Deloittes Strategy of 2008 is still being ignored. It is onlywith solid current clinical information can be make any difference in theadoption of improved clinical practice within the medical (and other clinical)professions.
As far asI can tell it is planned that the consumer portal will provide some usereducation features but for some reason this does not seem to be planned for theprovider portal. Why that would be just eludes me!
David.
