2019-10-27 at 9:42 pm #15222SaranathKeymaster
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?
2019-10-31 at 10:55 am #15353ChalermphonParticipant
My organization about Decision Support System seminary investigation decision making that are related with technology, Human and organization. Technology is a diseases surveillance systems to point with the outbreak disease from median tread of disease 5 years combine with the event based surveillance system and criteria of investigation diseases. Human is the verify teams and teams investigation to use the information and data to verify situation before action. organization to supports every functions and resources finally Leader decision to action or no action on events.
It’s working well on normal situation because of many factor that might influence the decision such as emergency situations such as flood, Earthquake , data loss, data error , missing data , no resource to support operation teams such as money, Personal Protection Equipment (PPE) on danger disease or chemicals events.
2019-11-01 at 1:49 pm #15372Pacharapol WithayasakpuntParticipant
Example of Decision Support System are indeed various smartphone apps that medical students get after graduated from medical schools. However, this varies by medical schools, and it might end at some time after graduation.
Smaller hospitals that I worked in are less likely to be able to afford most decision support systems; and they certainly don’t force doctors to use any electronic DSS.
Currently, there are indeed care maps, but they are electronic-based. The more electronic based might be eGFR calculation.
If electronic DSS is to be implemented, it might reduce paper use, at very least. But if I cannot prove that it improve outcome better than papers, it is less likely to be implemented.
2019-11-03 at 9:49 pm #15408
Hi..Patcharapon…I think small hospital is more in needs of DDS for their practices….the system will help reduce medical error…or time consumed for big decision or in the hospital that are in a shortage of specialist or number of practitioner…they can somehow rely on the DDS to make decision on their own…especially internist who are fresh off medical school and has to go on their compulsory scheme in rural area.
2019-11-01 at 2:55 pm #15375supawat.chtParticipant
Decision support system in our hospital is mainly a manual system running by our staff. For example, our nurse will notify doctor when the lab result is reported. I think that the major factor is the hospital policy since decision support system implementation will effects several levels and disciplines not only doctor.
2019-11-01 at 11:12 pm #15381
We have medical repatriation guidelines that work well but are a paper-based. The use is a manual without any IT support. The good news is that we are developing an RPA for our DSS and it is designed to be aligned throughout business processing too. The factors that I think will influence the implementation is system quality. The compatibility among business functions and their interests is challenging. For me, if the DSS requires too intensive data entry to be able to provide the decision support, adherence to the system may not be significantly decreased but information quality maybe so lowering impacted by inefficient data capture and entry. So I think in the time of development, they need to have all business functions come together in the designing process to make sure the workflow meets all stakeholders’s requirement.
- This reply was modified 4 years, 3 months ago by Ameen.
2019-11-02 at 12:00 am #15384tullaya.sitaParticipant
In my hospital, we have a clinical decision support system mostly are the alerts for the prescription.
In EMR program, we have an alert pop up box for patients who are currently using warfarin and also for patients with HLAB*5801 mutation that puts the patient at high risk of allopurinol (a drug for decreased level of uric acid in the blood) allergy. Besides the EMR program, we also have an electronics drug list of our hospital that can search for preparation, dosage, prices, and reimbursement to make a decision in prescription and decrease prescription error.
In views of general medicine practitioner, who usually focus on drug interaction side effects and polypharmacy, I think the pop up alert can help us much to remind before prescription and I do not feel much disturbed on this alert because I think it is the information that we should always know before making a prescription and there is not too much alert burden.
I really appreciated the drug list program because it helps a lot in reducing the prescription error. And I can discuss with the patient for the drug price and the reimbursement of what I want to prescribe before the prescription goes to the billing and pharmacy department. Furthermore, the data provided in that program also broaden my ideas to select the different kinds of drugs that suit each patient.
2019-11-02 at 3:01 pm #15390weerawan.hatParticipant
There are pop-ups reminding physicians during drug prescription, for example, history of drug allergy, particular drug dosage according to body weight, to sign in a form needed for some drugs. It can reduce prescription errors and it does not take much time to take a look.
Factors that might influence the decision support system implementation in my organization are
a. Belief in CDSS: can be positive or negative
b. Skill and experience in computer use
c. Experience in that field
2. Program and system
a. Provide patient-specific recommendation relevant for the clinical situation at hand and also a holistic overview of the patient
b. Easy to use, not time-consuming, be integrated with EMR or CPOE systems
c. Guidelines should be clearly visible on the screen in a visually oriented design, and include explanation about the recommendations
2019-11-03 at 10:14 am #15396w.thanacholParticipant
In hospital EMR, we are using decision support system mostly in drug prescribing system. The system will give an alert for drug allergy, drug interaction, repeated drug prescribing and pregnancy caution. It is able to reduce the incidence of drug allergy, and undesired drug interaction. The factor of its usefulness is it is alerted during the doctor prescribe the medication.
2019-11-03 at 9:52 pm #15409
Hi Thanachol…I have no experience in hospital setting…so Could you describe how the system works?
2019-11-24 at 11:48 am #15843Dr.Watcharee ArunsodsaiParticipant
In my hospital, we have a hospital information system (HIS) that can alert like a pop-up in the work flow in prescription and alert or reminder in laboratory results. As an example of Oseltamivir for pediatrician, it will show the pop-up for dosage for body weight, and other example for drug-drug interaction, over prescription for some drugs but not for drug allergy or adverse event or precaution like pregnancy yet.
2019-11-03 at 10:39 pm #15415NakarinParticipant
I had worked with the Auto-Validation program for reporting the medical laboratory results to the doctor. When the blood is tested by an automated machine in the lab, the results will be sent to the database. The data will be automatically reported to the department or doctor from the laboratory information system (LIS) to the hospital information system (HIS) if this data is passed the criteria that set by consideration of the doctor’s team and laboratory’s team together. The criteria are about the accuracy of the data such as the difference between the current value and previous value, how important of that result or critical value. If the data is not passed the criteria we set, these data will be stuck in LIS and the program will notify the laboratory’s staff to check that data an decide what to do next. The program helps us a lot that we do not have to review all of the results before report it to the doctor (such as the samples from the checking up department). But the problem is this program can not directly notify doctor in case of the patient have the critical value, laboratory’s staff have to notify doctor by phone. The program can not change the patient’s information in case of there is something changed after the patient’s information had imported to this program.
2019-11-04 at 12:02 am #15418Pyae Phyo AungParticipant
Our organization don’t have specific decision support system. We put alert and reminder in our EMR.
Just alert for side effects and investigation due date. Alert system is not well function. Not much clinicians are applying those alert system. Sometime they don’t even read it. They just click ok and skip the alerts and reminders. Clinician are not utilizing the EMR. They are just filling the data as they had to do it. Some laboratory information can not update realtime and the result are informed by formal method.
When the lab data are updated in the EMR, clinician already make the decision.
Laboratory result and patients history is the influencing factors for decision support system. If we can not update those information and make alert to clinicians, they will make their decision first and decision support system will be late to remind the clinician.
- This reply was modified 4 years, 3 months ago by Pyae Phyo Aung.
2019-11-04 at 8:34 pm #15438SaranathKeymaster
CDSS (if well designed) could provide a potential benefit to the EMR. The uses would see the benefit of filling data in the EMR system. However, if not well designed, the CDSS would be ignored and may create negative consequence to the EMR system.
2019-11-04 at 9:41 pm #15439THONGCHAIParticipant
Decision support system in my office is Health Data center (HDC) , in Health Data center (HDC) are share data from hospitals and health care center in ChiangRai.
HDC center show many data about patient medical record health care in module health information system report such as report of IPD and OPD patient , summary of chronic disease DM and hypertention , ANC , EPI ect.
Factors that might influence the decision support system implementation in my organization is code and structure data from health care center or hospital that not compatible standdard 43 files data set that can make wrong report system.
2019-11-10 at 12:11 pm #15540Penpitcha ThawongParticipant
My organization, DMSC, services HLA allele-specific genotyping Method for prevention of severe cutaneous adverse drug reactions: severe cutaneous adverse drug reaction (SCAR) and Johnson syndrome/Toxic Epidermal Necrolysis (SJS/TEN). 3 medicines show a high incidence of adverse drug resistance including Carbamazepine, Allopurinol, and Abacavir. Therefore, if a patient has got a causative allele we will report to the hospital for avoiding the use of that medicine. I don’t know this example can be CDSS or not, however, the incidence of severe cutaneous adverse drug reactions was significant decrease after we have the service.
2019-11-24 at 11:15 am #15822imktd8Participant
Due to my organization is not related to health or medical field, then I can only give you the example of DSS in the business term.
This DDS support the vice president to know about trend and predict data for planning budget for the next year. It benefits by reducing or controlling expenses, evaluating vendor, and add profit to the organization. In the term of the enterprise system, all transaction are recorded in SAP HANA system and DDS in install by SAP BW module.
For the factors the might influence the DSS implementation, because of a large amount of data and transaction. It hard to analyze data by MS Excel or customized program report only, then DDS is the better choice to provide report and information to support manager or vice president’ decision.
As learning from video and reading paper from the previous lessons, I think that CDDS in the medical context is very complex. Some data relate, but some not. Software implementation for CDDS is not easy, from requirement gathering, design, build, test, deploy to deliver and user in realy work. It need to enhance the program to get the up-to-date data because there is new finding happens everyday. At the present, there are new technology to increase accuracy, preciseness and effectiveness, for example, data analytics, matchine learning. If these technology is adapted to CDDS, I belive that it can help the physician can work better and happier.
2019-11-24 at 11:50 am #15845Dr.Watcharee ArunsodsaiParticipant
In my hospital, we have a hospital information system (HIS) that can alert like a pop-up in the work flow in prescription and alert or reminder in laboratory results. As an example of Oseltamivir for pediatrician, it will show he pop-up for dosage for body weight, and others fr drug-drug interaction, over prescription for some drugs but not for drug allergy or adverse event yet.
The CDS is working well for pediatricians as dosage of prescription, but may disturb the workflow for internal Medicine clinician because of pop-up alert. The lab result is just reminder for the clinician for abnormal value but not linked with other clinical decision.
There are some factors that might influence the decision support system implementation in my organization. The CDSS needs more man power and also knowledgable persons including the stakeholders (more clinician). The design of the system should be more user friendly and not disrupt the workflow. We need something like order sets and info button as well.
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