NHS England has released its implementation guide for the use of health IT in supporting clinical decisions, setting out the vision for clinical decision support (CDS) systems and suggesting key actions to be taken as a part of wider digital transformation strategies.
The guide highlights the “significant responsibility” borne by digital and clinical leaders, to consider their approach to implementation carefully, taking into account user needs, clinical workflows and patient safety. It emphasises the need to establish the right multidisciplinary teams, and for them to work toward a defined use case for CDS.
Some of the barriers to successful CDS implementation identified by the guide include alert fatigue, a lack of workforce engagement, and a need to ensure strong governance and quality assurance frameworks are in place.
The “success factors” laid out by the guide include the having the “five rights” – right information, or an evidence-based CDS incorporating stakeholder inputs and aligning with current improvement initiatives; right person, in ensuring that the CDS meets “the specific needs of everyone in the multidisciplinary team”; right format, presenting information “in a manner that complements workflows”, such as through a visual dashboard or customised referral; right channel, in relation to considering user experience needs and ensuring “presented information does not disrupt workflows” and integrates within existing EHR system where possible; and right time, embedding the CDS seamlessly within the clinical workflow.
The guide also looks at the “6i model for CDS systems”, outlining that CDS systems should be intelligent, interpretable, integrated, impactful, interoperable, and inclusive. It specifies that they should be evidence-based and address real-world clinical decisions; take into account staff knowledge of the topic; feature “mitigations made to reduce potential risks”; and be “based on trusted clinical data that is representative of the target population”.
The guide concludes by offering several examples of CDS system usage throughout the NHS, to help decision-making across areas such as highlighting important information, medicines management, and offering predictive analysis. To read it in full, please click here.
Earlier this year, we explored a study which examined the experiences of introducing new information systems in primary care organisations, with focus on the use of a CDS system to identify and diagnose malignant melanoma.
Our July panel discussion focused on taking a data-driven approach to operational improvements, day-to-day management, and proactive care, with our panellists considering the future of data use in healthcare and the need to make improvements across interoperability and usability of solutions for end-users.