Deck 10: Clinical Decision Support Systems in Healthcare

Question 1

Why have most clinical decision support (CDS) systems not shown to significantly impact patient outcomes in clinical trials, despite the fact that a majority of systems have been shown to significantly improve care processes?

A) CDS systems have not been evaluated in clinical trials.
B) Very few studies have assessed the impact of CDS systems on patient outcomes.
C) Many CDS system evaluation trials are underpowered to detect changes in care outcomes.
D) CDS systems have been implemented and evaluated in too many diverse institutions.

Answer 1

Many CDS system evaluation trials are underpowered to detect changes in care outcomes.

Question 2

Which group would have a financial incentive to implement CDS?

A) A community hospital
B) An inner-city clinic
C) A national insurer
D) Depends on CDS and healthcare payment model

Answer 2

Depends on CDS and healthcare payment model

Question 3

A healthcare system has implemented a functionality where patients who are overdue or almost due for a mammogram are sent letters notifying them to schedule a mammogram based on available data and current clinical care guidelines. Which type of CDS system is this?

A) This is not a CDS.
B) A personal health record system
C) A reminder system
D) An alerting system

Answer 3

A reminder system

Question 4

Which statement is not part of the Ten Commandments of CDS?

A) Speed is everything.
B) Fit into the user's workflow.
C) Alerting is the most effective approach to CDS.
D) Ask for additional information only when you really need it.

Question 5

Which incentive has the strongest potential to spur the nationwide adoption of advanced CDS?

A) Freely available CDS knowledge in a machine-executable form
B) Significant government funding for research efforts to share CDS
C) Shift of healthcare payment from a fee-for-service model to approaches rewarding the delivery of better quality and outcomes at lower cost
D) Meaningful Use Stage 1 requirements related to CDS

Question 6

Which tools are examples of CDS? (Select all that apply.)

A) An order set
B) A reminder
C) A phone call
D) An infobutton
E) An expert system

Question 7

Why is CDS important for healthcare institutions? (Select all that apply.)

A) It can reduce the need for registered nurses.
B) It can help reduce medical errors.
C) It is a required element of Meaningful Use regulations.
D) It can help improve care value.
E) It can slow the growth in use of facilities to manageable levels.

Question 8

Why are expert diagnostic decision support systems not integrated into clinical settings? (Select all that apply.)

A) They have not been shown to be comparable to the performance of human experts.
B) Clinicians generally must go out of their routine workflows to use the systems, and these systems generally require time-consuming data entry.
C) There are limited financial incentives to use such systems.
D) The systems have been found to be detrimental to patient care.
E) The software has been shown to be insecure.

Question 9

Which of the following are challenges or barriers to CDS adoption? (Select all that apply.)

A) Lack of evidence of CDS effectiveness
B) Misaligned financial incentives
C) Inadequate EHR adoption
D) Lack of widely adopted standards for CDS
E) Concerns over "cookbook medicine"

Question 10

Which of the following practices are included in the CDS Five Rights? (Select all that apply.)

A) Providing the right information
B) Providing to the right person
C) Providing at the right point in the workflow
D) Providing the right reference information
E) Using the right intervention format