IT pros home in on clinical decision support for stage 3

Advances in clinical decision support—and not only for clinicians—may be part of a smarter health information technology network of the future, according to members of a quality improvement subcommittee working on federal Stage 3 criteria for the meaningful use of electronic health-record systems.

The subcommittee on quality improvement, part of the meaningful-use work group, which is itself a subcommittee of the federally chartered Health IT Policy Committee, met on Monday to work its way through a list of several dozen proposed new criteria for the 2015 EHR federal incentive payment program.

Among the proposed criteria are several pertaining to clinical-decision support, including clinician alerts for drug interactions and allergies, and clinician identification of patients' preferred way to receive health communications.

The committee discussed the possible characteristics of future EHR systems, such as the ability to import updates of drug-drug interactions. These updates could alert clinicians to "never" combinations of drugs that must never be prescribed to the same patient at the same time. The updates should not be mere lists but should be in a form that yields data that is actionable by the importing EHR system, according to Dr. David Bates.

Bates heads the subgroup and is a member of the policy committee as well as its meaningful-use work group. He is senior vice president for quality and safety at Brigham and Women's Hospital and the Brigham and Women's Physicians Organization.

Future systems should do more for patients, too, according to fellow meaningful-use work group member Charlene Underwood, who serves as senior director of government and industry affairs at Siemens Healthcare Health Services. Patients should be given a choice of not just their preferred mode of communication but also the conditions for which they receive alerts, she said. They should be able to say, "I want an alert for this and I don't want an alert for that," she said. Underwood also is a former board chair of the Healthcare Information and Management Systems Society.