CMS: CDS more than just pop-up alerts

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 - clinical decision support

The Centers for Medicare and Medicaid Services (CMS) has released a clinical decision support tipsheet in which it is warning providers that when it comes to meeting Stage 2 Meaningful Use objectives clinical decision support (CDS) is more than just firing pop-up alerts.

Stage 2 requires eligible providers to implement five CDS interventions related to four or more clinical quality measures and implement functionality for drug-drug and drug-allergy interaction.

In the tipsheet CMS says that while providers may associate CDS with pop-up alerts, they aren’t the only, “or necessarily the best method” for providing support,” pointing out that pop-up alerts can only fire after an event has occurred.

It points out that one “proven use” of CDS is for abnormal blood pressure readings to appear in red text to differentiate them from normal blood pressure readings. According to CMS, this method doesn’t interrupt clinical workflow or risk that the alert will be ignored due to “alert fatigue.”

”CDS is not simply an alert, notification, or explicit care suggestion,” according to CMS. “Providers can meet the objective by using other kinds of CDS, including, but not limited to clinical guidelines; condition-specific order sets; focused patient data reports and summaries; documentation templates; diagnostic support; and contextually relevant reference information. In addition, CDS interventions are not only for doctors or nurses, but also for support staff, patients, and other caregivers and may be delivered outside of the examination room or treatment setting.”

Most importantly, says CMS, a CDS intervention should be based on “relevant, timely patient and care process information and that it may appear in ‘real time’ when it is most relevant to improve care provision.”