HIMSS CDS Guidebook Excerpts

The tasks, key lessons, worksheets, and key lessons below are part of the HIMSS CDS Guidebook titled, Improving Outcomes with Clinical Decision Support: An Implementer’s Guide. The information below will help guide you in understanding the definition of CDS and the foundation for the CDS 5 Rights.

Tasks

Establish a strong, shared foundation for yourself and your team around basic concepts such as the broad CDS definition and toolkit and the ‘CDS Five Rights’ framework. Use this foundation to underpin your efforts to develop a successful CDS program and target-focused CDS interventions. (Worksheet 2-2)
Begin building a shared vision among all those who will be touched by your CDS efforts about the role of CDS efforts in enhancing clinical, operational and financial performance.
Consider critical goals driven by internal and external forces that can inform strategic victories to be pursued and claimed as a centerpiece of your CDS program. Recognize that these drivers increasingly require measurable performance improvement, so include measurement (such as before and after CDS interventions) as a foundational element in your CDS approach. (Worksheet 2-1)
Become familiar with resources for information about CDS literature and best practices such as those provided by ONC, AHRQ and HIMSS.

Key Lessons

Clinical Decision Support is a process for ensuring that health-related decisions and actions are informed by pertinent patient information and clinical knowledge to enhance health and healthcare delivery.
CDS should be used as a strategic tool for achieving priority care delivery objectives. These objectives are driven by external forces such as payment models and regulations related to improving care quality, safety and costs, as well as internal needs for better efficiency and other performance enhancements.
Think of CDS broadly, not narrowly - it can involve different kinds of information that can be provided to many different care delivery participants in a variety of formats through different channels into various points in workflow. Addressing these collective information delivery dimensions appropriately to drive targeted improvements is referred to as ‘the CDS Five Rights.’
Be aware of situations where CDS has been shown to be of value, such as improving appropriate medication dosing, enhancing process measures related to preventive care, and decreasing mortality by increasing deep vein thrombosis prophylaxis.
Appreciate the limits of evidence about when and how CDS is most useful, and supplement this with best practices and insights from your peers.
Be familiar with known and sometimes unanticipated CDS pitfalls, such as failure to adequately address change management issues, and ‘alert fatigue’ from excessive or inappropriate alerting.

Worksheets

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