Friday, June 23, 2006

More on CDS

Earlier in the week, I wrote about Clinical Decision Support (CDS) on Hospital Impact. Recently the American Medical Informatics Association (AMIA) released a roadmap for the nation-wide implementation of CDS. I find this roadmap intriguing and I immediately wanted to explore the intersection between CDS and Evidence Based Medicine (EBM)

First, let’s define the terms:

Clinical decision support (CDS) provides clinicians, staff, patients or other individuals with knowledge and person-specific information, intelligently filtered or presented at appropriate times, to enhance health and health care (from AMIA roadmap).

Evidence Based Medicine (EBM) is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients (from Health Affairs).

If it isn’t evident from the definition, CDS is a primarily a process that is mediated by technology. The big question with CDS is how you get the right information to the right people at the right time. EBM, in one sense, is an activity that could be accomplished through CDS, but EBM can be much more than that. From my understanding EBM can be as simple as a healthcare provider using clinical research to influence a care decision. In this sense, EBM is more equivalent to CDS. But my experience with EBM also includes larger, more organizational practices, such as the implementation of clinical practice guidelines (presumably derived from clinical research). Implementing clinical guidelines is more than a technological process; it involves collaboration among physicians and nurses and the creation of monitoring and measurement processes. So CDS may assist in portions of the implementation of clinical guidelines (the identification of better-practices, the collection of clinical evidence, and the distribution of this information), but it does not necessarily provide for the entire process.

All of this to say that CDS and EBM do cross paths. Where they do cross, there will likely be applications developed that facilitate EBM. Where the two diverge is, in my opinion, fertile ground for innovation.


  • Interesting! I look forward to reading more of what you are doing. Hope to connect via blogging. I am a 29 year old occupational therapist, interested in many of the different aspects of health care. nice to meet you (virtually)!

    By Blogger communityhealthcare, at 9:54 PM  

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