Clinical decision support (CDS) will be a big part of healthcare in the near future. While CDS systems are not mainstream, they are becoming more popular and health IT must be ready. When people think of CDS they often think of Screen pop-ups that provide alerts, notifications and suggestions to support safety and quality objectives within healthcare. However, often times these triggers are challenges for CDS and create a barrier to the 5 rights of CDS which are:
- the right information
- to the right person
- in the right intervention format
- through the right channel
- at the right time in workflow
At the 3rd Annual Clinical Informatics Symposium presented by St. Louis Children’s Hospital and Washington University in St. Louis, Bimal Desai, MD, Chief Medical Informatics Officer at Children’s Hospital of Philadelphia talked about EHR Design to Support Safety and Quality Objectives. Dr. Desai talked about false positives and how they are enemy #1 for clinical decision support implementations. These triggers are put in place to provide alerts, notifications and suggestions to improve patient care, however, false positives often cause headaches. Because these alerts tend to pop up more times than not, healthcare providers tend to ignore them or override them – It’s like the tale of the boy who called wolf. Dr. Desai summed it up nicely by saying “if 99 of 100 phone calls you received were from telemarketers you would stop answering your phone.”
False positives get in the way of the 5 Rights of clinical decision support and are a barrier that need to be addressed if we want to get the right information to the right person in the right intervention format through the right channel at the right time.
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