A clinical decision support (CDS) system is an EMR / EHR associated system that provides an individual patient, real-time prompt. It gathers information from a patient’s EHR and existing medical evidence, and uses algorithms to determine clinical care recommendations or alerts for a particular patient.
Clinical decision support is a meaningful use criteria that needs to be met in order to receive government EMR incentive payments. However, clinical decision support is a vague term that requires further explanation.
According to the Eligible Professional (EP) Attestation Worksheet for Stage 1 of the EHR Incentive Program, the clinical decision support objective is:
- “Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance with that rule.”
The measure for this objective is:
- One clinical decision support rule is implemented. The measure only requires a yes/no answer.
Clinical decision support rules include drug interactions and drug-allergy issues, but in order to attain meaningful use, further requirements are needed for this criterion.
A certified EMR product must have a CDS system that uses data from a patient’s EHR, such as medication list, problem list, demographics, and test results. The system must be able to automatically generate real-time alerts and suggestions for care that comply with clinical decision support rules, in addition to drug interaction and drug-allergy checking.
For instance, if a patient is coming in for a checkup, there needs to be a dashboard indicating the tests that need to be done, what allergies the patient has, which drugs the patient is on, and other patient data. With a CDS systems, this prompt will exist for each patient and be updated automatically, ensuring safe and proper care.
Physicians may choose which CDS rule to report. This may be determined by which clinical decision support rules and notifications are featured in your EMR or by which are most applicable to your practice. Only 9 of the 44 measures are required to attain meaningful use.
The CDS rule you choose to implement, however, needs to be relevant to your specialty or is a high priority rule. Any of the 44 clinical quality measures listed for meaningful use are considered high priority. The clinical decision support rule you select also needs to be trackable for compliance.