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Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn

Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn. Overview of utilization and examples of CDSSs and eCPRs Brenda Courtney, Borislav D. Dimitrov,Tom Fahey. Overview of Presentation. Section 1 International Register of Clinical Prediction Rules (CPRs) Section 2

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Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn

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  1. Royal College of Surgeons in IrelandColáiste Ríoga na Máinleá in Éirinn Overview of utilization and examples of CDSSs and eCPRs Brenda Courtney, Borislav D. Dimitrov,Tom Fahey

  2. Overview of Presentation Section 1 • International Register of Clinical Prediction Rules (CPRs) Section 2 • Clinical Decision Support Systems (CDSSs)

  3. Section 1

  4. Electronic CPR Register • International electronic register of CPRs • Searchable electronic resource • Web based user friendly access • Manage and maintain register (Bates et al. 2003)

  5. Registry 1 2 3 4 5 6

  6. Section 2

  7. Clinical decision support system • Clinical decision support system (CDSS) • Systems that are designed to improve clinical decision making • Key points • Integrated with the electronic patient record • Available at the point of care • Computerised knowledge base • Provide patient-specific content

  8. Examples of CDSS

  9. Implementation Clinical Domain : Pharyngitis CPR : Centor Score • CDSS based on Bayesian reasoning • Reasoning engine • Software Algorithm • Combining Clinical Prediction Rules in registry to patient data • Communication mechanism • Input : Electronic Patient Record • Output : Diagnostic and therapeutic recommendations

  10. The Centor Score

  11. CDSS: CENTOR Score

  12. CDSS : Risk Stratification

  13. CDSS Management Recommendations

  14. CDSS Prescribing Recommendations Patient Specific

  15. Challenges to Implementation Knowledge Attitudes Behaviour Sources of Behaviour Change • External Barriers • Lack of time • Resources • GP Software companies • Poor integration into workflow • Lack of agreement • Uncertain application • Unclear applicability • Lack of familiarity • Time Investment • Inadequate infrastructure Barriers to Innovation Adapted from Lang et al.2007

  16. Summary Section 1 • Implement International Register for CPRs • Searchable across clinical domains • Public web based user friendly access • Maintained Section 2 • Implement Clinical Decision Support Systems • Knowledge base • Software algorithms [Bayesian reasoning] • Integrated in electronic patient record

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