Computerized decision support systems for multimorbidity care - an urgent call for research and development

Healthcare organisations and General Practitioners (GPs) in particular, are overwhelmed by the growing number of patients with multiple chronic diseases (i.e. multimorbid) and the additional complexity involved in their associated treatments. There is evidence to suggest that Computerized Decision Support Systems (CDSS) offer many potential benefits to support multimorbidity care, but this remains under investigated. For example CDSS have been shown to improve the quality/safety of medication prescribing; to increase clinician adherence to guideline/protocol based care; as well as to enhance communication and decision making among providers and patients. This chapter draws on extant literature to discuss these and other potential benefits of CDSS for enhancing multiborbidity care and calls for further research and development in this area. The chapter also identifies the required features of such software systems and underlines a number of key challenges that must be overcome for the successful deployment of CDSS in this context

Evaluating the effectiveness of clinical decision support systems: the case of multimorbidity care

General Practitioners (GPs) and healthcare systems, worldwide, are overwhelmed by the growing number of patients with multimorbidity, particularly in light of the additional complexity and costs involved in treating these patients. While it has been proven that clinical decision support systems (CDSS) play a key role in supporting healthcare decisions, there is little research into their role in the case of multimorbidity. This study examines practice systems currently used in Ireland and evaluates their effectiveness in such circumstances. The findings uncover a number of deficiencies, including: (1) the lack of provision of integrated medical guidelines for multiple chronic diseases within the CDSS, (2) the inability to centralise the patient rather than the disease, (3) the difficulty in seamlessly integrating CDSS into the patient consultation, and (4) the lack of adequate training of GPs on how best to use CDSS in multimorbidity decision making. The study underlines the need for further research into CDSS and multimorbidity, and highlights some of the key issues that must be addressed in order to improve how CDSS support the care of multimorbid patients