CDSS in Healthcare

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Questions and Answers

In the context of healthcare, what is the primary function of a Computerized Decision Support System (CDSS)?

  • To manage hospital finances and administrative tasks.
  • To replace the clinical judgment of healthcare providers.
  • To support healthcare providers in making informed decisions about patient care. (correct)
  • To automate all aspects of patient diagnosis and treatment.

What is the main goal of a Nursing Decision Support System (NDSS)?

  • To reduce the administrative workload of nursing staff.
  • To improve nursing effectiveness and determine the necessity for policy development. (correct)
  • To assist physicians in diagnosing complex medical conditions.
  • To replace nurses in clinical decision-making.

How do CDSS integrate with clinical data in a healthcare setting?

  • By providing training simulations for medical students only.
  • By operating separately from all patient-related data.
  • By integrating with the clinical data embedded in the computerized patient record. (correct)
  • By replacing the need for Electronic Health Records (EHR).

According to COIERA (1994), what role does CDSS play in healthcare?

<p>To augment human performance and aid healthcare providers with tasks prone to human error. (D)</p> Signup and view all the answers

One of the key purposes of a Decision Support System (DSS) is enhance the effectiveness of the decision-making process. What are the other two main purposes of a DSS?

<p>Assisting in problem-solving with semistructured problems and supporting the judgment of a manager or clinician. (B)</p> Signup and view all the answers

What is the significance of the early CDSS, developed by de Dombal in 1972 at Leeds University?

<p>It was among the first CDSS designed to support the diagnosis of acute abdominal pain, utilizing Bayesian theory. (A)</p> Signup and view all the answers

What is one of the functional characteristic of DSS?

<p>providing feedback to the clinician, organizing data, extent of proactive information, intelligent actions and communication method (D)</p> Signup and view all the answers

Which type of DSS relies on the user interface to support decisions?

<p>Graphics-based systems (A)</p> Signup and view all the answers

According to identified essential elements needed for an informatics infrastructure, which of the following would improve patient care?

<p>standardized vocabularies to describe patient diagnoses, interventions and outcomes (A)</p> Signup and view all the answers

Ethical and legal issues should be considered when using CDSS. Who bears the legal responsibility for the treatment and advice given to a patient?

<p>The clinician, regardless of whether a CDSS is used or not. (B)</p> Signup and view all the answers

What is the primary goal of a Clinical Decision Support System (CDSS)?

<p>Optimizing both the efficiency and effectiveness of clinical decisions and care delivery. (B)</p> Signup and view all the answers

A CDSS is designed to replace the judgment of a healthcare provider in making patient care decisions.

<p>False (B)</p> Signup and view all the answers

What is the main difference between a Nursing Decision Support System (NDSS) and a general CDSS?

<p>NDSS specifically targets nurses to improve their effectiveness and to determine areas in need of policy or protocol development.</p> Signup and view all the answers

According to one definition, CDSS involves 'computer software employing a ______ designed for use by a clinician in patient care'.

<p>knowledge base</p> Signup and view all the answers

Match the following CDSS examples with their functions:

<p>ONCOCIN = Oncology protocol management CASNET = Diagnosis and treatment of glaucoma ABEL = Manage acid-base and electrolyte imbalance</p> Signup and view all the answers

Which of the following best characterizes how Miller and Masarie view Decision Support Systems (DSS)?

<p>A catalyst approach, providing guidance while the user remains in control. (C)</p> Signup and view all the answers

The primary advantage of a CDSS is its ability to completely eliminate human error in clinical decision-making.

<p>False (B)</p> Signup and view all the answers

Name at least two key functions that a CDSS provides in healthcare settings.

<p>Administrative support for clinical coding, management of clinical complexity, cost control, and decision support.</p> Signup and view all the answers

According to Teich and Wrinn, triggering, dispatching and rule logic are ______ elements of a DSS.

<p>structural</p> Signup and view all the answers

What is the significance of a 'data-driven mechanism' in the evaluation of a CDSS?

<p>It enables event triggers that activate alerts and reminders automatically. (B)</p> Signup and view all the answers

According to the information, ethical and legal responsibilities for treatment and advice shifts from the clinician to the CDSS, when a CDSS is used.

<p>False (B)</p> Signup and view all the answers

What ethical consideration is most important when implementing a CDSS?

<p>That ethical and legal responsibility of treatment remains with the clinician, whether or not a CDSS is used.</p> Signup and view all the answers

A CDSS can be divided into data-based systems that capitalize on the fundamental input of any system, such as ______.

<p>data</p> Signup and view all the answers

Other CDSS uses include ONCOCIN, which was developed for oncology protocol management at what academic institution?

<p>Stanford (B)</p> Signup and view all the answers

A CDSS is a 'rule' system, not a 'tool' system.

<p>False (B)</p> Signup and view all the answers

What is the purpose of Nursing Decision Support Systems (NDSS)?

<p>They are tools that help nurses improve their effectiveness and determine areas in need of policy or protocol development.</p> Signup and view all the answers

In 1974, INTERNIST I was developed at the University of ______.

<p>Pittsburgh</p> Signup and view all the answers

According to sims et al, approximately what percentage of treatments used for patient care in internal and family medicine are supported with evidence of efficacy?

<p>50% (D)</p> Signup and view all the answers

Clin eguide is a type of clinical pathway constructor.

<p>True (A)</p> Signup and view all the answers

What is the objective of including integrated systems in healthcare settings?

<p>Combination systems offer optimal value to the organization.</p> Signup and view all the answers

Which of the following is NOT a characteristic of DSS?

<p>RANDOM (D)</p> Signup and view all the answers

A DSS is designed to assist in problem solving with fully strucutred problems.

<p>False (B)</p> Signup and view all the answers

A knowledge ______ is important in the evaluation of the CDSS.

<p>engineer</p> Signup and view all the answers

When was the first CDSS designed to support diagnosis of acute abdominal pain and at what university?

<p>1972, Leeds University (D)</p> Signup and view all the answers

A CDSS has a knowledge base designed for the patient to aid in clinical decision making

<p>False (B)</p> Signup and view all the answers

Flashcards

Decision Support Systems (DSS)

Automated tools designed to support decision-making activities and improve the decision-making process and decision outcomes.

Clinical Decision Support System (CDSS)

A CDSS supports healthcare providers in making decisions about the delivery of patient care.

Primary Goal of CDSS

The primary goal is to optimize both the efficiency and effectiveness with which clinical decisions are made and care is delivered.

Nursing Decision Support Systems (NDSS)

Tools that help nurses improve their effectiveness and determine areas in need of policy or protocol development.

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CDSS Includes

A set of knowledge-based tools integrated with clinical data in the computerized patient record (Electronic Health Record).

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CDSS Definition

CDSS has a knowledge base designed for clinician involved in patient care to aid in clinical decision-making.

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Human vs. DSS

The human has limited storage and processing power, but does have judgment, experience, and intuition. DSS integrate and capitalize on the strength of both.

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What is MYCIN?

A rule-based expert system to diagnose and recommend treatment for certain blood infections

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Integrated Systems

Combination systems offer optimal value to the organization, supporting organizational, executive/managerial, financial, and clinical decisions.

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CDSS Decision Support

supporting clinical diagnostic and treatment plan process promotion of best practices, use of condition-specific guidelines, and population-based management

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Computer-Based Clinical Decision Support Systems

Refers to systems that aid in healthcare decision-making.

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CDSS Focus

CDSS may focus on specific aspects of care.

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CDSS: Tool, not Rule

A CDSS is a tool to aid, not dictate, clinical decisions.

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DSS Purpose

DSS assist in problem-solving in situations lacking a clear structure.

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Earliest Known CDSS

To diagnose acute abdominal pain, developed in 1972.

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INTERNIST I (1974)

Developed at the University of Pittsburgh to support the diagnostic process by linking diseases and symptoms.

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Miller and Masarie

DSS approach provides guidance but keeps the user in control.

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COMMES and CANDI

Aim to assist nurses with care planning and intervention.

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ONCOCIN

Developed for oncology protocol management at Stanford.

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CASNET

Developed at Rutgers for glaucoma diagnosis and treatment.

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ABEL

Causal reasoning to manage acid-base and electrolyte imbalance.

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Functional Characteristics of DSS

Feedback, data organization, proactive info, actions, and communication.

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Logical Characteristics of DSS

Substitute therapy alerts, drug checking, and redundant utilization checks

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Structural Characteristics of DSS

Triggering, dispatching, logic, control, notification, action choices, execution and editor.

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CDSS Functions - Complexity Management

Keeping patients in research, chemotherapy protocols, tracking orders, referrals, follow-up, and preventive care.

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CDSS Functions - Cost Control

monitoring medication orders and avoiding duplicate or unnecessary tests.

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Data-based systems

Capitalize on the fundamental input into any intelligent system; data.

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Model-based DSS's

Driven by access to and manipulation of a statistical, financial, optimization, and/or simulation model

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Knowledge-based systems

Rely on expert knowledge that is either embedded in the system or accessible from another source.

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Graphics-based systems

take advantage of the user interface to support decisions by providing decision “cues” to the user in the form of color, graphical representation, options, and data visualization.

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Evidence-Based Practice

increasing need to use knowledge that is based on research at the point of care.

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Barrier to CDSS use

Only about half the treatments were supported with evidence of efficacy.

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Integrated Real-Time Patient Database

Needed to provide context for results interpretation.

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Data-Drive mechanism

Allows event triggers to go into effect and activates alerts and reminders automatically.

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Knowledge Engineer

Knowledge representation scheme used in the system.

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