EHRs With Clinical Decision Support Provide Better Care
By Katie Wike, contributing writer
A recent study has found electronic health records with clinical decision support improve quality of care.
Clinical decision support features of electronic health records (EHRs), required by parts of Meaningful Use Stage 2, have the potential to significantly improve care outcomes. According to Health IT Analytics, researchers from Brigham and Women’s Hospital, Harvard Medical School, and the Harvard School of Public Health used data from the 2006-2009 National Ambulatory and National Hospital Ambulatory Medical Care Surveys and focused on primary care visits at three types of EHR-enabled practices with CDS software meeting Stage 1 meaningful use requirements: those that had all available CDS features enabled, those that had disabled at least one feature, and those that were missing at least one CDS feature.
The five CDS features studied were, according to iHealth Beat:
● electronic problem lists
● lab result reports
● notifications for out-of-range labs
● reminders for preventive care
● warnings for drug interactions
“Physicians reporting use of CDS had patients with better blood pressure control and fewer visits related to adverse drug events,” say researchers in the American Journal of Managed Care. Those with electronic problem lists had better rates of blood pressure control and those with electronic lab results or notification of lab ranges were more likely to provide age-appropriate cancer screening.
When CDS features were disabled, quality of care declined. Researchers also said they were unable to determine an association between disabling particular CDS functions and cancer screening, health education or influenza vaccinations because of limited data.
“In contrast with some other studies, we found that the use of CDS functions was associated with improvements in measures of health quality at a national level,” the authors concluded. “In addition, decisions to disable these CDS functions, although infrequent, negated these increases in care quality. With the continued implementation of meaningful use, there should be a further decline in practices without EHRs or that choose not to implement or to disable CDS.”
“Overall, meaningful use standards that include [CDS functions] appear to have a significant positive effect on some national quality-of-care indicators and health outcomes.”