Clinical Decision Support Systems

Clinical decision support systems (CDSS) can be defined as “active knowledge systems which use items of patient data to generate case-specific advice”.

Practically speaking this is a computer program that automatically extracts information from the hospital information systems and presents it along with patient specific advice to the appropriate caregiver. Many different types of CDSS exist, varying in complexity, scale and effectiveness. They have the potential to improve patient care quality and efficiency, when implemented properly. An overview of types of CDSS in the Intensive care settings is given in our review paper "Patient specific clinical decision support systems in the intensive care setting".

Considerations for implementation and factors for success are described in our editorial for Pediatric Critical Care Medicine: Clinical decision support systems: Important tools when appropriately used. The editorial is a commentary on the review article "Clinical decision support systems in the pediatric intensive care unit" in the same issue.

Clinical decision support may also include logistical support; such as the implementation of a system that sends multiple paging alerts when a patient presents with an acute myocardial infarction to shorten the time to revascularization by percutaneous coronary intervention. The evaluation of such a pathway is important and may contribute to the effectiveness of the system. The 'door to balloon' times improved by 46 minutes after implementing three care improvement initiatives at the Charleston Area Medical Center in West Virginia. This included a fast-track cath lab protocol utilizing a 'cardiac alert', a physician initiated alert sent to multiple pagers. More results are described in the manuscript, published in Critical Pathways in Cardiology.