406 Clinical Decision Support Systems Instructor: Robert Cundrick, Ph.D.
Course Description:
The course provides an introduction to clinical decision support systems in health information technology. Instruction is given in formal decision analysis techniques as they apply to decisions in the medical domain. Clinical decision support systems are introduced and issues relating to their design and implementation discussed. The mathematical foundations upon which they are based will be examined. Evidence-based guidelines and performance measurement techniques will be presented. A framework for designing and implementing clinical decision support systems will be introduced. Principles learned from this framework will be applied in writing a final paper that describes a prototype decision support system, including justification for its use and a description of steps followed in its design, implementation and performance measurement. *
Text:
Hunink, H. & Glasziou, P. (2009). Decision making in health and medicine: Integrating evidence and Values (7th printing). Cambridge, England: Cambridge University Press.
Berner, E. S. (ed.). (2007). Clinical decision support systems: Theory and practice (2nd ed.). New York, New York: Springer, Health Informatics Series.
Osteroff, J. A., Teich, J. M., Levick, D., Saldana, L., Velasco, F. T., Sittig, D. F., Rogers, K. M., & Jenders, R. A. (2011). Improving outcomes with clinical decision support: an implementer's guide. Second Edition. Chicago, IL: HIMSS.
Berner, E. S. (ed.). (2007). Clinical decision support systems: Theory and practice (2nd ed.). New York, New York: Springer, Health Informatics Series.
Osteroff, J. A., Teich, J. M., Levick, D., Saldana, L., Velasco, F. T., Sittig, D. F., Rogers, K. M., & Jenders, R. A. (2011). Improving outcomes with clinical decision support: an implementer's guide. Second Edition. Chicago, IL: HIMSS.
Syllabus:
406_syllabus.pdf | |
File Size: | 204 kb |
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Reflections:
As I began to put together my thoughts regarding the Clinical Decision Support ( CDSS) course my focus was on the project, which was to develop a clinical decision support system. This was a major portion of the curriculum, however, as I began to review the course material I realized how much more there was to the class. The first few weeks we explored areas that are critically important to healthcare organizations especially with the climate of healthcare in the US. Topics included Meaningful Use, pay for performance, performance measure and outcomes, clinical guidelines, and unintended consequences of public reporting. Although pay for performance has its merits it needs additional research, planning and refinement.
Some of the probability exercises were quite challenging and it may have been advantageous to take Biostatistics prior to CDSS. The decision process using decision trees and sensitivity analysis were enjoyable exercises that illustrated how effective they can be, particularly when incorporating patient preferences. The course provided exposure to medical ontologies such as SNOMED, ICD-10, and RxNorm and explores how standard terminology is a key element in the interoperability between disparate systems and mapping between systems.
Although there is resistance from healthcare providers, a properly designed CDSS embedded into the EMR may be extremely beneficial in improving outcomes and cost containment, yet metrics must be in place to evaluate the usability and refine the system as needed.
The project my group chose was to develop a CDSS for Hormone Replacement Therapy (HRT) in postmenopausal women. We used a step by step process to develop and implement the system. The result was a streamlined system wherein the patient benefited, office visits with the physician were more productive , and a risk benefit analysis could be tailored to each patient evaluating their symptoms, along with information from the EMR. I enjoyed the project and think that Decision Support Systems have great potential, however , the key is that the systems are properly designed and implemented.
I cannot say enough good things about Robb Cundrick, the instructor for the course. He was engaged through the entire course and always available for help or questions no matter how trivial they were. When I was deciding which term to take the course, a classmate recommended I adjust my schedule in order to have Robb as an instructor and I am thankful that I did. Robb is extremely knowledgeable about the subject and it is obvious that he truly enjoys teaching. I am grateful that I had the opportunity to meet him.
Some of the probability exercises were quite challenging and it may have been advantageous to take Biostatistics prior to CDSS. The decision process using decision trees and sensitivity analysis were enjoyable exercises that illustrated how effective they can be, particularly when incorporating patient preferences. The course provided exposure to medical ontologies such as SNOMED, ICD-10, and RxNorm and explores how standard terminology is a key element in the interoperability between disparate systems and mapping between systems.
Although there is resistance from healthcare providers, a properly designed CDSS embedded into the EMR may be extremely beneficial in improving outcomes and cost containment, yet metrics must be in place to evaluate the usability and refine the system as needed.
The project my group chose was to develop a CDSS for Hormone Replacement Therapy (HRT) in postmenopausal women. We used a step by step process to develop and implement the system. The result was a streamlined system wherein the patient benefited, office visits with the physician were more productive , and a risk benefit analysis could be tailored to each patient evaluating their symptoms, along with information from the EMR. I enjoyed the project and think that Decision Support Systems have great potential, however , the key is that the systems are properly designed and implemented.
I cannot say enough good things about Robb Cundrick, the instructor for the course. He was engaged through the entire course and always available for help or questions no matter how trivial they were. When I was deciding which term to take the course, a classmate recommended I adjust my schedule in order to have Robb as an instructor and I am thankful that I did. Robb is extremely knowledgeable about the subject and it is obvious that he truly enjoys teaching. I am grateful that I had the opportunity to meet him.
Artifacts:
cdsss_hrt.pdf | |
File Size: | 2080 kb |
File Type: |