- This topic has 20 replies, 14 voices, and was last updated 3 years, 6 months ago by Kridsada Sirichaisit.
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2020-09-25 at 5:34 pm #22762SaranathKeymaster
Can you give an example of 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? -
2020-10-04 at 1:02 am #22980Ornpicha ThiampolParticipant
The Decision Support System used in my company is to report the critical laboratory result. There is an alarm when the result is out of range. It is working well as the system will notify automatically, so the laboratory technician knows and repeat the result. The factors that influence the decision support system is the system quality. As I know, the efficiency of the DSS system is a lack of immediate reports. This process takes time too long until it reports the critical range.
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2020-10-04 at 2:49 am #22983Wachirawit SupasaParticipant
In my experience, as a medical technologist, when some result has been over or under parameter, the lab system will make flagged in that result. For example, the normal range for Fasting Blood Sugar is below 100 mg/dL, from 100 to 125 mg/dL is prediabetic, and higher than 126 mg/dL is considered diabetic. If a patient has been fasting for more than 8 hours and the FBS level is over 126 mg/dL, the laboratory system will make “!” (exclamation mark) behind that result. This DSS will help a physician make the decision easier and faster.
However, some experienced physicians might not trust this system completely and they will request a retest for that patient or ignore them completely. -
2020-10-06 at 12:50 am #23013Saravalee SuphakarnParticipant
One an example of decision support system in the animal hospital where I work is diagnostic support system in EMR program. A veterinarian need to input problem list of the patient then the system analyze the data and generate possible disease/syndrome and the advices for further diagnosis. The concept of the CDSS is look like good and helpful for veterinarians to diagnose problems but it isn’t good when use in real clinical practices. Problems that I found when use the system such as the system didn’t recognize medical technical terms that were input, the result that the system generated wasn’t related with the problems (base on practitioner background knowledge). Finally, didn’t have any veterinarian in the hospital used the system and this system have been removed.
The factors that might influence the system including
1. The system understanding of practitioner : the program provider should train about the system and program working to the practitioner.
2. The Database of the system : it should cover internal medical knowledge as much as possible, that is accuracy of the system, and should be update.
3. The algorithm of the system : it should be reliable. -
2020-10-07 at 3:27 pm #23185Pongsakorn SadakornParticipant
In my division, TanRabad-watch which is a web-based application to visualizes dengue outbreak by integrating patient data and environmental data (HI, CI) has been used for monitoring and observed dengue outbreak especially decision support for the intervention. This application can point-out the dengue outbreak area in the sub-district level and can look historical of dengue data in the area. However, patient data delay and duplicated of patient data is the main factor that influences the decision support.
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2020-10-09 at 4:21 pm #23222Sittidech SurasriParticipant
Thanks for sharing your experience in using the DSS/CDSS in your origination. I would like to add te factor that would influence to the DSS implementation would consider about HUMAN (Data entry, Decision maker).
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2020-10-07 at 7:55 pm #23186Kridsada SirichaisitParticipant
In my hospital I use the NI surveillance system to control NI rate.
It’s work only when I announce the report of emerging NI. It’s work in some area but some area must command for infection control like a incident commander in EOC.
I think DSS is only tool but success factor is the health personnels to use it. -
2020-10-08 at 5:16 am #23191SaranathKeymaster
Interesting to learn many CDSS from you all. The implementation of the CDSS is much more challenging than building it.
– Support on disease diagnosis (per Saravalee’s comment)- clinical diagnosis and treatment is a complex process that involves not only knowledge, but also doctors or Vets have to consider other contexts (such as social and mental). This is not quite a straight forward. This is why most clinicians tend to against this system. We should emphasize or make the clinicians understand that this system is not meant to replace the physician’s decision, but it aims to help or support their decision making.
– Alert fatigue: Many CDSS provides too often alerts (sometimes are false alerts). Once it happens for a period of time, the users will start to ignore the alert. -
2020-10-08 at 10:47 pm #23205Rawinan SomaParticipant
DSS in my experience from the past usually comes in the reminder and alert. The reminders are the pop-up message from the previous visit after the patient’s interface was selected. The alert comes in many forms such as critical lab result alert, drug allergy alert, and drug interactions. These features aim to reduce the clinical error and improve quality of care. This system is user-friendly and did not interrupt the current workflow. In my opinion, they are influencing factors to implement DSS.
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2020-10-08 at 11:18 pm #23206Sila KlanklaeoParticipant
As previously seen, it is a data processing system to forecast the number of patients who will come to receive services each day. To use as information in decision making To prepare the staff for the care and the tools to be ready to serve patients.
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2020-10-09 at 4:15 pm #23221Sittidech SurasriParticipant
My background is a medical technologist and worked in the hospital laboratory. I have no experience in using DSS/CDSS in my organization. However, one example that I think that DSS was used in supporting the project that studied about Antimicrobial resistant and Antimicrobial use in the human and animal health sectors. The project used “WHONET software” for the management and analysis of microbiology laboratory data with a special focus on the analysis of antimicrobial susceptibility test results.
The data from the WHONET were used in clinical decision support, antimicrobial use policy, infection control and outbreak detection, identifying laboratory test performance, and characterization of local microbial and resistance epidemiology.
Another example of application that we have just learned “ eMIS (electronic Malaria Information System)” would consider be the DSS as well.After review the article “Factors influencing implementation success of guideline-based clinical decision support systems: A systematic review and gaps analysis.
E. Kilsdonk∗, L.W. Peute, M.W.M. Jaspers that used the HOT-fit framework to find the gap. I think that the factors might influence the decision support system implementation include of:
– Human: is a major factor that influence the DSS implementation; Person who enter the data, Person who use the data.
– Technology; WHONET also have the gap; quality and quantity of data that will use to support the decision.
– Organization -
2020-10-11 at 11:06 am #23246Navinee KruahongParticipant
Unfortunately, at a policy decision making level, in the Department of Mental Health we don’t have any kind of ehealth or information system that is used to provide information supporting policy decision making. Most of policies always come from a group of persons- general director and experts. They review and use best practices from other countries, and sometimes they just want to do something new, which doesn’t have any evidence support. Currently, we have been trying to create an information system of mental health active screening. However, with the low quality of method and tools of collecting data, data from this system is not considers as a good data to support policy decision making.
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2020-10-11 at 6:35 pm #23257Kaung Khant TinParticipant
I agree with you. Most of the decision makers and policy makers in my country also usually do not take into consideration of the ground conditions as well as the perspective and opinions of the staff who are working at the ground level. Because of that, when the decisions and policies are implemented , they do not fit well into the system.
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2020-10-11 at 7:21 pm #23259NaphatParticipant
As same as my office, we have no any program of decision support system, We just following guildline of the SOPs as daily routine work and discussion with supervisors ( From their experiences and professional in each dicision).
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2020-10-12 at 2:11 am #23284Ornpicha ThiampolParticipant
This is a challenging topic ever that needs to collect big data to support the decision. If there is a good tool to collect the data from other countries then review by the specialist. Maybe it works but DCSS cannot replace all processes in policy thinking.
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2020-10-21 at 12:25 am #23447Kridsada SirichaisitParticipant
I think data in metal health system is very difficult to collect and use it in an information because many data is subjective data not like laboratory data that is numerical data and I’m not sure in accuracy of collect data. Then how to design data system of mental health is the important in my opinion.
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2020-10-11 at 6:31 pm #23256Kaung Khant TinParticipant
In our organization, OpenMRS electronic medical record software is used in giving treatment and care to the people living with HIV. And decision support system is integrated to the software, but not a fully supportive one and stands just as a part of the existing EMR. There are many limitations in it, and it only supports just a few clinical decisions.
Some of them include “a reminder to the clinician to give Isoniazid Preventive Therapy if the patient does not have TB or any TB symptoms”, “info button regarding WHO staging of HIV”, “a display of which laboratory tests are high, normal or low, calculating from the results”, and “a reminder to do routine viral load test when it is due”. And it is working well.
But the problem is that the clinicians already know and understand the suggestions and supports that come from the decision support system, and they do not feel that they benefit from the system implementation. Anyway, on the bright side, the system is intuitive and user-friendly and presented in a visually oriented design. But on the other hand, some of the clinicians complain that the system takes time and prolongs the working hours at the clinic. And at some sites, it cannot be operated fully as the electricity is not stable. Moreover, this decision support system is still needed to be operated in order to function well.
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2020-10-11 at 11:46 pm #23265Khaing Zin Zin HtweParticipant
Dear Kaung Kaung, although we work in the same organization, I just get to know about OpenMRS providing decision support due to different projects. It would give more benefits to project outcomes if we can add automatic drug suggestion based on patient’s medical history and lab results.
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2020-10-11 at 11:50 pm #23266Khaing Zin Zin HtweParticipant
Currently, there is no system implemented for decision support in my project. But the one I would like to develop is presumptive TB referral system. Since all contacts of TB patients need to be investigated regularly during course of treatment of the index patient, reminders for regular follow up would reduce the chance of missing TB patients among contacts. And also, presumptive referral among community members would be easy by entering their symptoms and risk factors into the system. However, we might need to consider the availability of budget for infrastructure and human resources.
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2020-10-12 at 12:03 am #23268Phone Suu KhaingParticipant
Can you give an example of 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?Actually, we do not have DSS currently in my project.
Just from learning from reading materials and videos, factors influencing implementation of DSS shall be perception of users and level of supportiveness of DSS to users. -
2020-10-12 at 3:11 pm #23288Navinee KruahongParticipant
The development of evidence-based policy need information technology!
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