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Customer Experience and Design

Clinical Decision Assist Part II – Real Time Clinician Support

In part I we discussed the value of near real-time analytics to support clinical care delivery. As promised we wanted to next discuss the power of Clinical Decision Assist – providing clinicians with the ability to effect change while the ability to do so still exists. Near real-time analytics environments are difficult to develop, especially in the provider environment. So is it really worth all of the effort? Stay tuned and let’s find out.

Medication conflicts, poorly executed care plans, care team communication issues, and lack of adherence to best practices and standard order sets are all frustrating and preventable events. These events can all lead to patient complications, and in that case increased costs of care and impacted Core Measure and other quality reporting, let alone lawsuits and the impact on the actual patient. And to think that they could have been completely avoided in the first place.

What if the medical record and or pharmacy system, once integrated, could alert a prescribing physician or delivering clinician to a possible deadly or damaging complication. What if the charge nurse and or Chief Nursing Officer and Chief Medical Officer were alerted when clinicians strayed from care plans and standard order sets? Some times there are justified exceptions. But that is normally not the case. These best practices were put in place for a reason in the first place.

I speak from experience. Several years ago I was rushed into surgery when my Appendix ruptured and I became septic. The surgery was successful but I wasn’t given blood thinners or boots and developed a pulminary embolism that almost killed me. They also took my stomach tube out before hearing bowel sounds and ended up impacting my intestines. Due to these complications I was in the hospital for over two weeks, and if my physician father hadn’t noticed some of the mistakes, probably would have died. Again both of these complications were due to human error and completely avoidable. If a clinical assist system was in place the caregivers could have avoided these problems, or clinical leaders would have been alerted before it was to late.

These examples are all related to procedural adherence. But this same system could be used to identify epidemics, or lead to a primary diagnosis faster. The system can help to connect all of the dots. This will never replace the role of the clinicians and caregivers, but can definitely assist them as they work in complex fast paced and often under staffed environments.

So what is keeping us from getting there? Of course, you will have to stay tuned for part III!

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