Practical Applications of EMR Optimization Through Clinical Decision Support – #HITsm Chat Topic

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 5/18 at Noon ET (9 AM PT). This week’s chat will be hosted by Justin Campbell (@tjustincampbell) from @GalenHealthcare on the topic of “Practical Applications of EMR Optimization Through Clinical Decision Support”


As a primer for the upcoming Health IT Expo, we will be discussing practical applications of EMR optimization through clinical decision support. Optimization dominates Health IT leaders’ list of priorities as they seek to rationalize EMR investment and harness its capabilities for improving efficiency, care and outcomes. However, boil-the-ocean approaches to EMR optimization can be counterproductive and stifle progress. Instead, Health IT leaders would be best served to focus on practical applications of optimization – specifically through clinical decision support, which serves as a lynchpin to clinical quality improvement initiatives.

Clinical decision support (CDS) provides clinicians, staff, patients or other individuals with knowledge and person-specific information, intelligently filtered or presented at appropriate times, to enhance health and health care.

CDS has a number of important benefits, including:

  • Increased quality of care and enhanced health outcomes
  • Avoidance of errors and adverse events
  • Improved efficiency, cost-benefit, and provider and patient satisfaction

CDS encompasses a variety of tools to enhance decision-making in the clinical workflow. These tools include:

  • Computerized alerts and reminders to care providers and patients
  • Clinical guidelines
  • Condition-specific order sets
  • Focused patient data reports and summaries
  • Documentation templates
  • Diagnostic support, and contextually relevant reference information

The majority of CDS applications operate as components of comprehensive EHR systems, although stand-alone CDS systems are also used. Many modern EMRs contain CDS capabilities such as rule engines, predictive modeling languages, and alert and order set authoring. However, the development and use of effective CDS within the EMR requires significant clinical, IT, and knowledge management resources that many organizations do not possess. This has led an increasing number of organizations to use compartmentalized decision support platforms other than EMR to drive portions of their CDS programs.

Ideally, CDS tools will be readily accessible to a wide array of caregivers where and when they need them, irrespective of what electronic health record they’re using. One such initiative emerging to share CDS resources is the AHRQ-funded CDS Consortium Project, which has demonstrated successfully that CDS from Partners Healthcare could be delivered to disparate EMRs across the country.

In an age of overwhelming data access and rapid technological development, ensuring clinicians have the clinical decision support tools to sift through a sea of information to find what is most relevant to their patient’s needs is vital to optimizing health outcomes.

In this tweetchat, we will discuss types of CDS (including sepsis surveillance, risk calculators, drug interaction, among others), mechanisms to deliver CDS to the point of care, workflow and alert fatigue implications, and methods for sharing proven CDS libraries.

Resources and Other EMR Optimization & CDS Reading:

  1. EMR Optimization Whitepaper
  2. EMR Optimization Infographic
  3. HealthIT.gov Clinical Decision Support
  4. CDS in the Cloud: Deploying a CDC Guideline for National Use
  5. Almost 20 Percent of CDS Alert Dismissals May Be Inappropriate
  6. EHR vendors, AHIMA push use of clinical decision support to prevent patient falls
  7. EMR Sepsis Surveillance – Achieving Optimal Sepsis Sensitivity & Specificity
  8. Integrated Health Calculators Whitepaper

Join us for this week’s #HITsm chat where we’ll discuss the following:

T1: What experiences do you have with CDS implementation? What impacts (positive and negative) did it have? #HITsm

T2: How can CDS best be deployed to the point of care without exacerbating alert fatigue? #HITsm

T3: How are different types of CDS initiatives (VTE, sepsis detection & prevention; clinical pathways implementation; risk calculation) prioritized? #HITsm

T4: Is CDS best suited to be managed by EMR vendors or can CDS be shared across vendors? How? #HITsm

T5: What are strategies to manage to CDS code and clinical peer review and rating? #HITsm

Bonus: What are mechanisms for making knowledge artifacts for CDS shareable? #HITsm

Upcoming #HITsm Chat Schedule
5/25 – TBD
Hosted by Amanda (@LALupusLady)

6/1 – #HITExpo Hiatus
The #HITsm chat will be on hiatus this week with the Health IT Expo happening in New Orleans. Please join in on the conversation happening on the #HITExpo conference hashtag.

6/8 – TBD
Hosted by Jeanne Bliss (@jeannebliss)

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

About the author

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

2 Comments

  • Great topic. Justin lets connect I wanted to introduce you to a new CDS on the block, it is an evidence based lab CDS that gives a unique medical relevance score for each lab-dx pair, with full literature references and associated labs at each stage in the workup. Super useful for routine workups and more complex genetic / bio marker labs. Addresses over and under utlization which any good CDS should do today.

  • That sound extremely compelling Dr. Giannulli. Look forward to discussing on the tweetchat. Do you have literature you can share with application of this evidence-based lab CDS? I’ll make sure to research in advance of the TC. Talk on Friday!

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