Decision time for clinical decision support systems

Clinical decision support systems are interactive software systems designed to assist clinicians with decision making tasks, such as determining a diagnosis or recommending a treatment for a patient. Clinical decision support systems are a widely researched topic in the Computer Science community but their inner workings are less well understood by and known to clinicians. In this article we provide a brief explanation of clinical decision support systems and provide some examples of real world systems. We also describe some of the challenges to implementing these systems in clinical environments and posit some of the reasons for limited adoption of decision support systems in practice. We aim to engage clinicians in the development of decision support system that can meaningfully help with their decision making tasks and open up a discussion about the future of automated clinical decision support as a part of healthcare delivery

Physician Learning and Clinical Decision Support Systems

Despite the documented benefits of clinical decision support systems in reducing the number of adverse drug events (ADEs) and medication errors, their adoption has been very limited. In this paper, we propose a clinical learning model that incorporates the use of a Clinical Decision Support System (CDSS) to improve the decisions on the initial drug selection and ongoing dosage and application. The model allows for the analytical investigation of the effects of different CDSS functionalities on clinical learning. The analytical results suggest that using CDSS to improve drug selection decisions positively influences the importance of the patient-level information for the physician. On the other hand, absent improvements in successful drug selection, the use of CDSS may in fact negatively influence the clinical learning

Mobile Clinical Decision Support Systems – A Systematic Review

In this review article, we provide a descriptive analysis of the current state of mobile decision support systems in the healthcare domain based on studies published in the following databases: Business Source Complete, CINAHL, Cochrane library, MEDLINE, PsycINFO, PubMed, ScienceDirect and Web of Science databases. A total of 29 studies were identified and analyzed to understand the current state of development, evaluation efforts, usability and challenges to adoption by patients and care providers. Our aim is to evaluate these systems and identify the key challenges which hinders their widespread adoption. Although, mobile based decision support systems in healthcare context have the potential to improve clinical decision making, the current state with low adoption rate and early stage of development need to be addressed for successful health outcomes

Meta-design Knowledge for Clinical Decision Support Systems

Knowledge gained from a Decision Support Systems (DSS) design should ideally be reusable by DSS designers and researchers. The majority of existing DSS research has mainly focused on empirical problem solving rather than on developing principles that could inform solution approaches for other user contexts. Design Science Research (DSR) has contributed to effective development of various innovative DSS artifacts and associated knowledge development, but there has been limited progress on new knowledge development from a practical problem context, going beyond product and process descriptions. For DSS applications such as Clinical Decision Support Systems (CDSS) design and development, relevant reusable prescriptive knowledge is of significance not only to understand mutability but also to extend application of theory across domains. In this paper, we develop new design knowledge abstracted from the approach taken in a representative case of innovative CDSS development, specified as an architecture and six design principles. The CDSS design artifact was initially designed for a specific clinical need is shown to be flexible for meeting demands of knowledge production both for diagnosis and treatment. It is argued that the proposed general strategy is applicable to designing CDSS artifacts in similar problem domains representing an important contribution of design knowledge both in DSS and DSR fields