- In an age of overwhelming data access and rapid technological development, ensuring clinicians have the clinical decision support tools to sift through a sea of information to find what is most relevant to their patient’s needs is vital to optimizing health outcomes.
Medical errors in prescription and medication dosing were named the third leading cause of death in the US in 2013. Giving clinicians access to the right information at the right time through evidence-based clinical decision support can prevent these errors and reduce instances of patient harm.
"Medication errors are frequent and common, and order entry systems where they enter dose and the medication can do a lot of crosschecking and decrease errors," said Regenstrief Institute Research Scientist Paul Dexter, MD. "That’s one of the most established of areas or domains in technology improving safety. At an early stage, it was shown that order entry systems can decrease medication errors by somewhere in the range of half — through legibility, preventing errors of accidentally being off on one’s dosage by an order of magnitude."
In choosing a clinical decision support technology vendor, clinicians are looking for solutions that are both consistent and individualized to fit their healthcare organization’s particular needs.
"Physicians, whether they’re specialists or generalists, we tend to want rapid access and we like things presented in a certain type of format," said Chief Medical Officer of Elsevier Clinical Solutions Peter Edelstein, MD. "We learned it in med school. We learned it internships and residencies. We process information very quickly looking at certain types of charts, tables, and synoptic content. That’s true whether your ER doc or an OB, whether I’m doing surgery in Vermont or doing dermatology in California."
All individuals involved in the various aspects of patient care benefit from support tools aiding informed clinical decision making. While pharmacists, physicians, nurses, and patients may need different information, all involved parties need the assurance their information comes from a single trusted source keeping everyone on the same page.
"It is extremely important to format and deliver it in the way appropriate for each one of those four groups. At the same time, it has to say the same thing fundamentally. That’s the single source of truth. It can’t have competing, conflicting instructions or we have our current disaster," Edelstein stated.
Despite a crowded market, a select few vendors armed with expansive databases dominate the market for clinical decision support systems (CDSS). While the needs of physicians in ambulatory and inpatient settings differ, some clinical decision support system vendors demonstrate the capabilities to meet the demands of both branches of the industry.
The following are the top five clinical decision support system vendors for ambulatory and inpatient settings based on data from Definitive Healthcare.:
As the number one clinical decision support system provider among physician practices, First Databank gives physicians informative messages through alerts within existing applications. Named the highest-rated drug database by KLAS, First Databank is currently in use at thousands of ambulatory care facilities worldwide. The vendor’s clinical decision support technology specializes in installations of e-prescribing, EHR, EMAR, and CPOE systems and prioritizes delivering concise, immediate electronic messages to physicians offering up-to-date drug information for active clinical decision support.
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Medispan offers clinical decision support at the point of care through time-efficient, real-time online and mobile applications to aid clinicians in ensuring patient safety and improved health outcomes. Medispan embeds drug reference knowledge into existing healthcare systems to support safe medication decisions while also meeting federal regulatory demands and market needs. The clinical decision support company’s machine-readable solutions provide detailed medication classification surpassing mandated industry standards to reduce the potential for drug prescription errors.
Allscripts clinical solutions are designed to aid clinicians in streamlining clinician’s search for patient health records by ensuring efficient EHR transactions across the care continuum. Allscripts Core Clinical offers clinical decision support tools for various physician care units including acute, ambulatory, emergency and surgical care. With adaptable solutions tailored to fit to any setting, including small practices, Allscripts focuses on providing physicians with cost-effective, interoperable clinical decision support through nearly 800 clinician-reviewed Care Guides.
Cerner clinical decision support software uses a nationally-vetted set of evidence-based standards and criteria to give clinicians reliable guidance to ensure patients receive the proper treatment for their specific needs. Cerner offers clinical decision support for a range of healthcare services from advanced imaging and radiology to mobility. Cerner provides clinicians with up-to-date information integrated into existing EHRs and clinical workflows to allow for accurate ordering and prescription leading to optimal patient care.
Elsevier, a worldwide publisher of scientific, technical, and medical information products and services, offers a suite of clinical decision support tools to aid clinicians at the point of care. Elsevier’s evidence-based medicine and prescription information provides clinicians with answers to any clinical questions, as well as drug decision support, predictive data analysis, and online training. Elsevier equips providers with tools ranging from drug information to learning and competency management to improve patient outcomes for pharmacists, physicians, and nurses.
Truven Health Analytics
Truven Health Analytics offers hospitals evidence-based clinical decision support and patient education through Micromedex resources designed for seamless integration into existing hospital EHR systems through standardized application programming interfaces (APIs). Truven allows healthcare providers access to clinical decision support regarding medication, disease, and lab information from a single source from any hospital or facility. Truven Micromedex clinical decision support solutions are currently in use in over 3,500 hospitals.
Zynx Health clinical decision support tools aid hospitals in improving patient outcomes, financial operations, clinical engagement, and technology performance. Zynx evidence-based tools offer clinicians information and workflow suggestions and encourage collaboration between stakeholders and clinicians to improve clinical and financial outcomes. Zynx also provides content libraries to integrate up-to-date theories into clinical workflows and clinical services to adapt information to fit the specific goals of any health organization.