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How to Implement EHRs

Clinical Decision Support (CDS)

Clinical decision support (CDS) is defined as a process for enhancing health-related decisions and actions with pertinent, organized clinical knowledge and patient information to improve health and healthcare delivery. Achieving these benefits requires CDS interventions that address the CDS Five Rights. 

Such interventions provide:

  1. the right information (evidence-based guidance, response to clinical need)
  2. to the right people (entire care team – including the patient)
  3. through the right channels (e.g., EHR, mobile device, patient portal)
  4. in the right formats (e.g., order sets, flow-sheets, dashboards, patient lists)
  5. at the right times (for key decision or action)

Resources for Improving Care with Clinical Decision Support

Below are tools and resources that can assist the care team in identifying appropriate clinical decision support interventions and that can be implemented along with workflow optimization to improve outcomes on priority goals (for example, better management of patients with hypertension). 

Resource Overview

Reviewing a presentation to RECs (HIT Regional Extension Centers) about the material below as it was being developed will help orient you to it:

Introduction to CDS

Clinical Decision Support Fundamentals Presentation: Describes essential concepts related to CDS and quality improvement (QI)

Clinical Decision Support and Quality Improvement Worksheet Presentation: Describes worksheets to document, analyze, and improve workflow and information flow related to care improvement targets

CDS/QI Worksheets and Examples

CDS/QI Essential Worksheets- Essential: Essential versions of ambulatory and inpatient CDS/QI worksheets that will assist in documenting, analyzing and planning enhancements to information flows for specific quality improvement goals. Essential versions are especially useful for initial CDS/QI analysis, brainstorming and planning.

CDS/QI Worksheets – Detailed: Robust ambulatory and inpatient CDS/QI worksheets that build on the simplified worksheets by adding space to document ‘optimal state’ information flows and ‘CDS 5 Rights’ details for the improvement target. Detailed versions are especially useful for clarifying current ‘who, what, when, where and how’ information flow details for the target and ensuring that planned enhancements will deliver desired results (by better approximating ideal processes).

Providers Demonstrate Quality Improvement

CDS/QI and Meaningful Use

Meaningful Use Stage 2 Objectives: The CDS/QI approaches outlined in the resources on this webpage can help providers achieve many of the MU objectives outlined in these documents:

2014 Meaningful Use Clinical Quality Measures (CQMs): Below are resources containing 2014 CQMs and related information. These measures define important targets for CDS-enabled quality improvement efforts.

Tipsheet on Clinical Decision Support for Meaningful Use

CDS Guidebook Extracts

Tasks and Key Lessons: “Tasks” and “Key Lessons” from “Improving Outcomes with Clinical Decision Support” provide detailed, bulleted guidance on what should be known and done for effective CDS/QI efforts

Worksheets: Worksheets referenced in the “Tasks” and “Key Lessons” above can support many CDS/QI activities

Improve Specific Clinical Goals

Additional CDS/QI Resources