A CDSS is a system which assists in the clinical decision making process by providing updated and current information. Clinical Decision Support Systems (CDSS) have been evolving for the last thirty years and they really are not a new...
moreA CDSS is a system which assists in the clinical decision making process by providing updated and current information. Clinical Decision Support Systems (CDSS) have been evolving for the last thirty years and they really are not a new concept. The focus of these systems has however undergone a substantial change and they are now being designed to actually support the clinical decision making process. The earliest models were more of a source of information and were similar to databases. Then the 'critic' model was developed which was based on accepted evidenced based protocols and wherein a clinician could check with the system as to the completeness of his clinical plan. It would then suggest improvements to the proposed plan. They can assist in varying tasks such as administrative, clinical, pharmacy (prescribing), laboratory result reporting, etc. They have become so specialized that in 2003 an attempt had been made to classify them (Sim and Berlin, 2003). The main advantage of using a CDSS (Clinical Decision Support Systems) is that it can be very handy in working under stress and in busy settings. They can keep treatments according to protocols and hence reduce the rate of clinical errors. The theme of using EBM (Evidenced Based Medicine) to achieve optimum benefit for the patient is one of the fundamental principles in clinical governance (Boissel et al., 2003). Managed care and the medically literate public are expecting health practitioners to adhere to accepted guidelines and hence practice in a more or less uniform pattern. DSS are now in development which is based on accepted protocols, developed by experts in their respective fields (van Oosterhout et al., 2003). Prescribing errors can be reduced as medicines can be checked for suitability, drug interactions when a pharmacy DSS is used. The concept of CPOE (computerized physician order entry) has become familiar today amongst informaticians. Here the physician's orders are directly entered electronically into a computer, which being networked to a information system and running a CDSS in the background checks for validity of the order according to established guidelines, drug dosage is verified according to the patient's age or body weight and drug interactions and allergies are intimated immediately at entry. Studies done in ICU (Intensive Care Units) have been encouraging of this method of prescribing (Lillis, 2003). Managed care and clinical governance, in order to control unnecessary tests, have made it necessary for doctors, especially GPs to follow guidelines in requesting procedures such as CT and MRI scans (Bindels et al., 2003). These guidelines when inbuilt into the CDSS the GPs use, work in the background to monitor the requests for such costly procedures and suitably intimate the physician when it may not be acceptable.