During his many years at Brigham and Women’s Hospital in Boston, Jonathan Teich, MD, PhD, has helped with the design of many of its CPOE, EHR and CDS applications and, in his words, has been “talking about CDS in one form or another for decades.”
Next month at the Association of Medical Directors of Information Systems (AMDIS) Fall Symposium in Boston, Teich, who is CMIO for Elsevier and co-chair of the event, will again deal with the subject of CDS, but this time from what he feels is a different direction.
“How do we get from the current state of CDS to a successful future?” he wondered. “We know what has happened in terms of CDS right now—we’ve all touted the same examples.” Yet, the ability to address some clinical problems through CDS “quickly and easily” is still problematic, he said.
During the symposium he plans on addressing what should be done in several areas going forward. “How do you make things widely available?” he asked. “What is being done now and what could be done in the future to make good CDS widely available? That has to do with the availability of CDS registries and catalogs, with being able to set up an operating system for CDS that that most vendors will support and that we can drop CDS into more easily than we can currently.
“It’s really about how we look at CDS and take something that is good in one place and make it available in another place,” he said.
Teich pointed out that these are areas that he has "dabbled in" for years, whether it’s been through his involvement with the Dept. of Health and Human Services-sponsored Roadmap for National Action on Clinical Decision support or work he’s done with the Office of the National Coordinator for Health IT on CDS related to Meaningful Use. “Frankly, I think the subject needs another kick in the pants,” he said. “I want to spend some time thinking about that and some models people have been thinking about to make all of this much simpler.
“I’ve often said that if a new drug was invented tomorrow then every hospital in the country that wanted it would take the drug and log it into their Pyxis or Sure-Med machine and it would be there and they could start using it,” Teich said. “But if a new CDS guideline or rule was invented tomorrow everyone would set up committees and work with their vendors to actually figure out how to format it, and 18 months later we might have it in 15 percent of the hospitals that want it. We want to put a stop to that.”
He’ll also talk about CDS and the Learning Healthcare System. “Can we actually start to use the data we are collecting to generate new recommendations on the fly and do research based on our common clinical experiences?” he asked.
Whoever is attending the symposium—whether a CMIO, nursing leader or informaticist—is bound to be dealing with CDS “heavily” from the standpoint of their hospitals’ quality needs, Teich said.
“People have quality reporting requirements and we are getting into quality improvement requirements on a national and payer level,” he pointed out. “Inside of the hospital there is a legion of things you have. I know in our own practice at the emergency department at Brigham and Women’s we are constantly being guided and checked on for things like our ordering of antibiotics or our use of certain kinds of imaging procedures.
"CDS is all about bring the best practices to the top of your mind when you need it,” he said. “I don’t know if everyone completely recognizes that CDS can help you do that, but when you show it to them it is something that can be very compelling."
The AMDIS Fall Symposium will be held October 20-21 at the W Boston Hotel. Click here for registration details.