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Chap 7. Penetration and Availability of Clinical Decision Support in Commercial Systems 2010. 4. 12 김석일. Contents. INTRODUCTION CDS PENETRATION AND AVAILABILITY IN COMMERCIAL SYSTEMS CLINICAL ALERTING IN 2002 OBSTACLES TO CDS IN 2002 WHAT CHANGED SINCE EARLY 2002?

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  1. Chap 7. Penetration and Availability of Clinical Decision Support in Commercial Systems2010. 4. 12김석일

  2. Contents • INTRODUCTION • CDS PENETRATION AND AVAILABILITY IN COMMERCIAL SYSTEMS • CLINICAL ALERTING IN 2002 • OBSTACLES TO CDS IN 2002 • WHAT CHANGED SINCE EARLY 2002? • A Preview of Findings from CPOE Inquiries 2002-2005 • Changes from 2002 to 2003 • Changes from 2003 to 2004 • Changes from 2004 to 2005 • HOW FAR ALONG ARE CDS VENDORS IN 2005? • Miscellaneous Commentary from Live Users • SELF-REPORTED VENDOR DATA AS OF FEBRUARY 2005

  3. INTRODUCTION • Did not appear until the early 1970s • 1970s : 10 to 15 organization attempted to build their own clinical systems with CDS • KLAS • Specifically targeted the use of CDS (alerts, prompts, guidance, etc.) in commercially available software for acute organizations since 2001

  4. INTRODUCTION • Discussion points • Cover only vendors and products that are designed and used generally (by clinicians and mainly physicians) • Not focused on narrow niche • Respiratory therapy, medication administration, oncology, etc • Will not discuss CDS that occurs specifically within a typical pharmacy information where checks for interactions such as drug-drug, drug-allergy… available in virtually every pharmacy information system marketed today • First Data Bank, Maltum…

  5. CDS penetration and Availability in Commercial Systems • HELP • Developed by Homer Warner, MD, PhD in early 1970s

  6. WHAT CHANGED SINCE EARLY 2002? • A Preview of Findings from CPOE Inquiries 2002-2005 • Changes from 2002 to 2003 • Changes from 2003 to 2004 • Changes from 2004 to 2005

  7. Changes from 2002 to 2003

  8. Changes from 2003 to 2004

  9. Changes from 2004 to 2005

  10. HOW FAR ALONG ARE CDS VENDORS INCE 2005? • Miscellaneous Commentary from Live Users

  11. SELF-REPORTED VENDOR DATA AS OF FEBRURY 2005 • Cerner Self-Reported • Eclipsys Self-Reported • Epic Self-Reported • GE Self-Reported • IDX Self-Reported • Mckesson Self-Reported • Meditech Self-Reported • Misys Self-Reported • Siemens Self-Reported

  12. CONCLUSION

  13. Chap 8. LESSONS LEARNED

  14. ACADEMIC PROTOTYPES • Nature of the Project • Pilot or prototype? • Consequences for Operation • Time & cost • Local Differences • Platform dependence • Maintenance and Update

  15. De facto lifecycle process for rule-based clinical decision support at Partners healthcare

  16. STANDARDS AND SHARING OF INTEROPERABLE CONTENT AND TOOLS • Arden Syntax • GELLO

  17. USERS • Extra-effort is needed

  18. OTHER CONSIDERATIONS

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