Comparison of Computer-based Clinical Decision Support Systems and Content for Diabetes Mellitus.

Area of Science:

• Health Informatics
• Clinical Decision Support Systems
• Diabetes Care Management

Background:

• Computer-based clinical decision support (CDS) systems enhance care quality and efficiency.
• Electronic health records and CDS are crucial for healthcare reform in the US.
• Significant heterogeneity exists in CDS content and infrastructure across different healthcare sites.

Purpose of the Study:

• To assess the scope of CDS content and capabilities in diabetes care across six institutions.
• To characterize the infrastructure of CDS systems in use.
• To identify successful implementation characteristics of CDS in diabetes care.

Main Methods:

• Comparative analysis of CDS systems across six sites within the Clinical Decision Support Consortium.
• Gathering of CDS content related to diabetes mellitus patient care.
• Surveys on institutional characteristics, CDS infrastructure, and capabilities.

Main Results:

• Significant variation in CDS approaches and content characteristics among sites.
• Commonalities include user customizability, sophisticated exclusion criteria, and automated decision-making integration.
• Most sites utilized monitoring and prevention rules, with numerous reminders for screenings and vaccinations, but fewer diagnostic or treatment suggestion rules.

Conclusions:

• Computer-based CDS systems exhibit wide variations in content and scope.
• Both in-house and purchased CDS systems share common functionalities.
• Key features include workflow integration of alerts/reminders and actionable recommendations for providers.