Optimizing Decision Support With Human Expertise

Clinicians need access to current and accurate evidence-based information to deliver the best possible care to patients. But wading through vast amounts of medical literature—and trusting it—is too often challenging at the point of care. Here, Truven Health Analytics' Tina Moen and Jill Sutton share their expertise on what effective clinical decision support should look like, and how trusted information can improve outcomes for patients.

CG: How is trusted decision support content put together?

JS: Creating trusted clinical and management decision support requires a rigorous process consistently followed by a team with clinical experience trained in advanced literature evaluation techniques. Editorial governance should incorporate critical evaluation of the clinical research to ensure that clinical recommendations included in the database are based on statistically sound literature, rather than just adding the latest published articles.

TM: It's also important for clinical content to be reviewed by people who have been on the receiving end—people who have worked for provider organizations and understand the types of real-life questions our clients need to be able to answer using their own and national data resources. Truven Health's editorial and analytics team, for example, consists of 125 pharmacists, nurses, and nurse practitioners, data scientists and analysts. Having clinicians on the team and content reviewed by content experts ensures the content presents clinically relevant evidence to help our clients make patient care decisions.

CG: How can clinicians sort through the barrage of medical updates and information that emerge, to provide the best care?

JS: We know a gap exists in the time it takes for research to get into clinical practice--often due to the vast amount of, sometimes conflicting, information. The best clinical decision support content takes a systematic approach to literature surveillance to provide information that is actionable and practice changing. Clinicians don't have time to search through hundreds of journals or try to find that one piece of information, so clinicians must rely on credible resources to provide relevant recommendations.

CG: What types of questions should effective clinical decision support content answer?

TM: Everyday little questions, such as dosing common medications, all the way up to big questions such as rare treatments for complex diseases. Effective decision support tools should provide built-in analytics from point-of-care content so that hospitals can continually improve the quality of care they deliver.

An example of this in my own career, we had a pediatric patient with a systemic fungal infection who ended up being allergic to every medication that we tried. At the time, I sat down with Micromedex and did some research into the comparative efficacy sections and therapeutic indication information to try to figure out what else could we try to prescribe for this patient to solve his medical problem. The comprehensive information in Micromedex provided a couple of alternative therapies to recommend to the physician, one of which resulted in effective treatment for this complex patient scenario.

CG: How can effective decision support content improve outcomes for hospitals?

JS: An effective clinical decision support system is aimed at reducing variance in clinical practice and identifying gaps in care to improve outcomes. When hospitals establish a standard of care using evidence-based best practice that is driven through a clinical decision support system, and then routinely evaluate and benchmark against those standards, the organization can target key opportunities for outcome improvements.

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