Decision support systems (DSS) are automated tools designed to support decision-making activities and improve the decision-making process and decision outcomes.
A CDSS is designed to support healthcare providers in making decisions about the delivery of patients care.
The primary goal of CDSS is the optimization of both the efficiency and effectiveness with which clinical decisions are made and care is delivered.
Nursing decision support systems(NDSS) are tools that help nurses improve their effectiveness, determine areas in need of policy orprotocol development.
—CDSS includes a set of knowledge based tools that can be fully integrated with the clinical data embedded in the computerized patient record (Electronic Health Record).
—CDSS may focus on treatment, diagnosis, or specific patient information.
—CDSS is a “tool system”, not a “rule” system.
CDSS- has a knowledge base designed for the clinician involved a patient care to aid in clinical decision- making.
1994- “computer software employing a knowledge base designed for use by a clinician involve in patient care, as a direct aid to clinical decision making
2001- “CDSS are software designed to be a direct to clinical decision-making”.
COIERA- discussed the role of CDSS as augmenting human performance and providing assistance for healthcare providers especially for tasks subject to human error.”
The application of CDSS helps clinician access and use what science has learned.
EXPANDED USE OF CDSS:
Randall Tobias
- the former VP of ATT is credited with saying that if the advances in power, storage capability, and cost of computers today were compared with the mainframes of the 60s and 70s, it would be like getting a Lexus for $2.00 that went 600mph and used a thimble of gas.
EXPANDED USE OF CDSS:
Randall Tobias
- the former VP of ATT is credited with saying that if the advances in power, storage capability, and cost of computers today were compared with the mainframes of the 60s and 70s, it would be like getting a Lexus for $2.00 that went 600mph and used a thimble of gas.
The human, on the other hand, has limited storage (memory) and processing power, but does have judgment, experience, and intuition.
> DSS integrate and capitalize on the strength of both.
THREE MAIN PURPOSES OF A DSS ARE TO:
> Assist in problem solving with semistructured problems
> Support, not replace, the judgement of a manager or clinician
> Improve the effectiveness of the decision-making process
> DSS integrate and capitalize on the strength of both.
THREE MAIN PURPOSES OF A DSS ARE TO:
> Assist in problem solving with semistructured problems
> Support, not replace, the judgement of a manager or clinician
> Improve the effectiveness of the decision-making process
HISTORY OF CDSS:
Early systems Focus on Diagnosis:
One of the earliest known CDSS designed to support diagnosis of acute abdominal pain was developed by de Dombal in 1972 at Leeds University. This system used Bayesian theory to predict the probability that a given patient, based on symptoms, had one of seven possible conditions.
In 1974, INTERNIST I was developed at the University Of Pittsburgh to support the diagnostic process in general internal medicine by linking diseases with sympstoms.
Early systems Focus on Diagnosis:
One of the earliest known CDSS designed to support diagnosis of acute abdominal pain was developed by de Dombal in 1972 at Leeds University. This system used Bayesian theory to predict the probability that a given patient, based on symptoms, had one of seven possible conditions.
In 1974, INTERNIST I was developed at the University Of Pittsburgh to support the diagnostic process in general internal medicine by linking diseases with sympstoms.
OTHER CDSS USES:
ONCOCIN- developed for oncology protocol management at Stanford.
CASNET- developed at Rutgers University for diagnosis and treatment of glaucoma.
ABEL- an expert system developed at MIT that used causal reasoning to manage acid-base and electrolyte imbalance.
ONCOCIN- developed for oncology protocol management at Stanford.
CASNET- developed at Rutgers University for diagnosis and treatment of glaucoma.
ABEL- an expert system developed at MIT that used causal reasoning to manage acid-base and electrolyte imbalance.
TYPES AND CHARACTERISTICS OF CDSS
ADMINISTRATIVE AND ORGANIZATIONAL SYSTEMS
-included in the field of healthcare decision support are systems that support organizational, executive/managerial, financial, and clinical decisions.
INTEGRATED SYSTEMS
-healthcare agencies have begun to understand that combination systems offer optimal value to the organization.
ADMINISTRATIVE AND ORGANIZATIONAL SYSTEMS
-included in the field of healthcare decision support are systems that support organizational, executive/managerial, financial, and clinical decisions.
INTEGRATED SYSTEMS
-healthcare agencies have begun to understand that combination systems offer optimal value to the organization.
CHARACTERISTICS
-These systems can be studied based on their structure, their organization, their content, or their purpose.
TEICH AND WRINN –examines DSS from the aspects of functional and logical classes and structural elements.
1. FUNCTIONAL- feedback provided to the clinician, the organization of the data, the extent to proactive information provided, the intelligent actions of the system, and the communication method.
-These systems can be studied based on their structure, their organization, their content, or their purpose.
TEICH AND WRINN –examines DSS from the aspects of functional and logical classes and structural elements.
1. FUNCTIONAL- feedback provided to the clinician, the organization of the data, the extent to proactive information provided, the intelligent actions of the system, and the communication method.
2. LOGICAL- includes substitute therapy alerts, drug family checking, structured entry, consequent actions, parameter checking, redundant utilization checking, relevant information display, time based-checks, templates and order sets, and profile display and analysis, rule-based event detection, and aggregate data trending.
3.STRUCTURAL- according to Teich and Wrinn include triggering, dispatching, rule logic, process control, notification/ acknowledgement, action choices, action execution, and rule editor.
3.STRUCTURAL- according to Teich and Wrinn include triggering, dispatching, rule logic, process control, notification/ acknowledgement, action choices, action execution, and rule editor.
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