- This topic has 22 replies, 17 voices, and was last updated 2 years, 6 months ago by Weerada Trongtranonth.
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2021-09-22 at 10:13 pm #31557SaranathKeymaster
Can you give an example of a Decision Support System used in your organization? Is it working well? Are there any factors that might influence the decision support system implementation in your organization?
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2021-09-29 at 9:08 pm #31721Auswin RojanasumapongParticipant
– An example of a decision support system used in my organization is the notification system of the patient. There are many possible messages of the notification that can pop up when opening the patient’s history page, such as drug allergy, loss follow up of any clinic, need annual screening for tuberculosis, or even the patient has not paid for hospital fee from the last visit. While this system works well and helps many clinicians to prevent error and misdiagnosis, the system does not specify the type of messages that show to the specific personnel. For instance, the pop-up about the patient’s debt does not need to show to the clinician. While this is a minor problem of the system, it could be improved to concise the information each person needs and prevent notification fatigue.
– The factor that might influence the DSS to implement in my organization is the system quality which mostly involves ease of use and time efficiency. If the system is easy to learn, easy to use, and does not require much time to adapt to the system, the DSS would be accepted by the clinician.
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2021-10-01 at 6:10 am #31767SaranathKeymaster
Too many unnecessary alerts in the CDSS could potential cause “alert fatigue”. This could discourage people to use the system.
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2021-10-06 at 4:03 am #31878Anawat ratchatornParticipant
Thank you for sharing.
My organization experienced same situation like you.
Those notification might be helpful but it can be too much that make providers ignore it.
I think that to solve this problem, the system should be better designed on which information should be shown more specifically.
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2021-10-02 at 8:56 pm #31815Arwin Jerome Manalo OndaParticipant
The closest technology that I had used that functioned as Clinical Decision Support System is UpToDate. The website contains a lot of useful, up-to-date, concise, and relevant information on a particular disease or disorder. It provides schematic diagrams on triaging a person and eventually, the appropriate treatment to be given. There are also array of tools for use of clinicians (eg. calculators, drug interaction checker). It contains brief results of the clinical trials and studies considered in generating recommendations. Further, there are always hyperlinks or short explanations whenever there are unfamiliar texts in a paragraph. In terms of accessiblity, it has a mobile app – allowing easy access of information right at the fingertips of its intended users.
Some major downsides of UpToDate is that, it is expensive. Second, it usually needs institutional access (or through VPN) for it to work.
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2021-10-02 at 9:45 pm #31817TARO KITAParticipant
I don’t have any experience using a Decision Support System (DSS). However, some researches tell of the negative factors influencing the implementation of the DSS such as interference with existing hospital workflows, clinician’s concern about the communication with patients, their unfamiliarity with the newly introduced system or poor computer literacy, fear of leading to mechanical decision making.
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2021-10-03 at 3:16 pm #31827Karina Dian LestariParticipant
I do not have any experience using DSS in my organization yet.
One factor that might be the influence for an organization to use DSS is the functionality and advantages, particularly in epidemiology and surveillance. It would be easier to monitor and assess key indicators of the disease. Although, I agree that too many alerts can cause alert fatigue. So the alert should be something that is really important, such as giving an alert if there is an outbreak so health officers can take necessary action immediately. -
2021-10-03 at 8:40 pm #31833Tossapol PrapassaroParticipant
Example of clinical decision support in my workplace which are
1. Alerts system for laboratory report, when the blood test results are out of normal range, they will show us in red instead of black text. The other alert system would be the notification if the patient received high alert drugs such as warfarin and the potential for other medicines to interact.
2. Drug list Info button which shows us the detail of the drugs, such as, tablet’s picture, classification, preparation, and mechanism of drugs
3. Artificial intelligence for chest radiograph interpretation alerts us by adding red/yellow/green areas if there are any suspicious abnormalities in the chest radiograph image.For me, the alert system is working well without interrupting me too much. Drug list info buttons also work excellent; however, the Ai for chest radiograph is too sensitive to report that they detect an abnormality, which actually seems normal.
The factor that influences the CDSS implementation in my organization would be the system should be compatible with workflow. The alert system would alert only for the critical information. The CDSS should have the practical benefit or make a significant change for safety and efficacy reasons.
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2021-10-05 at 6:56 pm #31865Sri Budi FajariyanParticipant
The data obtained from the surveillance information system becomes a DSS in the malaria program. For example, information on the number of cases per province is used to allocate the amount of funding needed to carry out an epidemiological investigation. Another example is the strategy of integrating malaria testing for pregnant women, focusing only on high malaria endemic districts. This policy was implemented because based on the data it is known that more than 90% of malaria cases in pregnant women occur in high endemic districts
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2021-10-06 at 3:59 am #31877Anawat ratchatornParticipant
There were some example of CDSS that I experienced.
1. Alert system on EHR.
– This alert system popped up to warn providers about drug interactions, duplicated order, etc. This could be very helpful for patient safety, but, in reality, there were too much alert that resulted in disturbing provider work.2. Drug information
– I am not sure that it could be categorized as CDSS. There were drug information, including trade name, generic name, drug group, drug interaction, and ingredient, of each drug available to read. This function might not help physician in term of suggestion, but it was very helpful in term of information providing to assist physician to make a decision.3. AI assist chest x-ray interpretation
– This was just an initial state of implementing AI. So it didn’t affect much on reality work. AI interpreted chest x-ray image and predict possibility of each diseases in percentage of possibility.According to above examples, in my opinion, factors that influence implementation of CDSS might be
– Accuracy of its information and how information help in reality.
– Time efficiency. for example, although alert system might be very helpful, too much alert might consume too much time to read and action.
– Where is CDSS in the reality workflow. -
2021-10-06 at 2:35 pm #31894Navin PrasaiParticipant
In the Decision Support System different alerts, reminders, and notifications are used to aid in decision making.
In my Organization, the reminders are updated on the message board. All healthcare professionals go through the message boards which makes them alert about their responsibilities. Abnormal lab reports, abnormal X-ray findings are also highlighted with different color combinations to bring immediate healthcare attention which helps for the positive health outcome of the patients.-
2021-10-08 at 9:44 pm #32019Napisa Freya SawamiphakParticipant
Thank you for sharing. I agree on creating some unique point can increase the users’ attention, to avoid missed alert!!
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2021-10-06 at 2:58 pm #31895Ashaya.iParticipant
The example of Decision Support System used in my organization are included;
– the pop-up about patient situation at that time such as admission details (e.g. ward no., bed no. etc.), their current accident event details and the next appointment details.
– Drug allergy, precaution, chronic disease alert to support the decision about prescription drug issue.In my perspective, all these system working well but I’m not sure that those pop-up or alert can be seen in every sector or it can only see by authorized people. If it can see in every sector, some of unnecessary data for some sector such as showing alert of patient with financial problem to physician sector, it can causes ‘notification fatigue’ as Dr.Auswin mentioned.
The factors that influence the decision support system implementation including the hospital try to improve the service quality to support patient’s need, reduce the time to serve the service to patients, facilitate the healthcare worker to coordinate to each other and work effectively, and also develop the standard of the healthcare service.
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2021-10-06 at 7:53 pm #31912Napisa Freya SawamiphakParticipant
I also face similar situations with everyone, especially Auswin. I don’t have a decision support system in my organization recently but when I was in the hospital, there was a pop-up drug notification to alert on drug allergies, drug expiration, a special group with precaution, drug interaction and etc. It is very useful to prevent duplicated medication/drug interaction. However, as it is very sensitive, it could alert easily with unnecessary information. Hence, the healthcare workers could get alerts a lot and get used to it. It may lead to alert fatigue and many workers tend to ignore the alerts due to overloaded alerts/usually unnecessary, which increases the risk of missing important alerts. It may affect patient safety. I think it would be nice if the decision support system can classify and rank the alert based on the level of importance, reduce unnecessary alerts and use different text/box colors to identify the important alert, to prevent overloaded alerts and easy for professionals to focus.
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2021-10-06 at 9:44 pm #31926chanapongParticipant
I have experienced some of CDSS in my organization
1.CPOE
-It is very helpful for its alert about drug interaction, drug allergy, and dosage calculation. But, there is some limitation about repeating notification in some patients who were exempted and confirmed to use medication that caused interaction, which is not serious.2.AI in medical imaging
– Analysis of medical imaging like chest radiograph could help to detect abnormalities, that may not be detected, and reduce misdiagnosis.The influencing factors to support CDSS are how efficient and reliable their systems are. Other points are how this system can generally be used and the perspective of the user to the CDSS.
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2021-10-13 at 7:17 pm #32085Auswin RojanasumapongParticipant
AI in medical imaging is very useful. My hospital also has this system that can help to identify the abnormality of chest X-rays and reduce the chance of misdiagnosis. Very useful for screening for tuberculosis.
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2021-10-06 at 9:46 pm #31927Theekhathat HuapaiParticipant
Most of my experience with Decision support systems (DSS) is simple HosXP alert.
– Drug alert system
This is a standard DSS that I use every day. Drug alert systems may be drug allergy alerts, drug interaction alerts. This Alert is a simple instruction within HosXP. Sometimes, Alert is so annoying because it is the knowledge that I know already. They are no distinction between drug allergy and side effect.
– ICD coding helper
This is also a simple instruction within HosXP. It helps doctors find desired diseases easily. But this usually applies to simple diseases. The more complex disease with a different part of the body still does not have support yet.
– Laboratory alert system.
A laboratory alert system enables nurses to contact doctors rapidly. This isn’t a disease-specific system. Doctors must interpret data.
From my point of view. Factors that might influence the DSS in my organization are as follow. An easy-to-use DSS needs to be developed. Reduce unnecessary alerts, Develop for doctor needs. May be integrated medical guidelines within the system.-
2021-10-08 at 2:33 pm #32000Anawat ratchatornParticipant
ICD coding helper sounds very interesting and helpful.
In my point of view, it would be good to apply it with SNOMED CT that designed for clinical aspects, and then it can be mapped between two standards.
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2021-10-08 at 6:46 pm #32016Hazem AbouelfetouhParticipant
I don’t have any experience with DSS. However, I think modern EMR systems provide physicians with many alerts and reminders in the workflow in prescription, laboratory results, and writing clinical observation which is considered a part of Clinical Decision Support.
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2021-10-16 at 12:36 am #32198Pimthong SinchaiParticipant
Like other, I don’t have any experience with Decision Support System (DSS). For example , in healthcare system, DSS help diagnose a patient, a medical clinician may use a computerized decision support system for diagnostics and prescription. Combining clinician inputs and previous electronic health records, a decision support system may assist a doctor in diagnosing a patient.
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2021-10-19 at 2:30 pm #32271Weerada TrongtranonthParticipant
I experienced a drugs alert system which notified when we prescribe drugs that the patient has history of allergy. Its very helpful and reduce human error.
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