Clinician Input Will Shape CDS Programs

By Katie Wike, contributing writer

A new campaign from Regenstrief Institute and Indiana University will use physician input to design computer based decision support programs.

Computer-based decision support is about to get a makeover from the Regenstrief Institute and Indiana University. Their new approach uses clinician input to design and improve CDS rules. “What if electronic medical users could conveniently write decision support rules based on personal experience with the patients they serve?” asked researchers. “That's possible now with RAVE.”

RAVE, short for Rule Authoring and Validation Environment, allows doctors with authorized access to an electronic health record system to quickly write CDS rules “that embed the clinician's own thinking into the computer system so it's passed on automatically to other system users.” FierceEMR outlines an example where “the clinician can create a high priority pop-up alert or a low priority one; an alert can be customized for just one patient or created broadly for all of them.” This does not require any computer programming experience and also includes a system of checks and balances which requires testing before deployment.

“With the introduction of RAVE's distributed approach to clinician decision support rule writing we are incentivizing creativity from the bottom up – something which isn't typically done in healthcare,” said Titus Schleyer, DMD, Ph.D., director of the Regenstrief Institute's Center for Biomedical Informatics in a press release. “We have developed an organizational and technical approach to put rule authoring capability directly into the hands of motivated clinicians – partially turning the typical balance of power regarding how EMRs function upside down.

“With RAVE any physician, nurses, pharmacist or other clinician with authorized access to an electronic medical record system can write clinical decision support rules that embed knowledge – part of his or her own thinking – into the system so the computer passes it along automatically to other system users. And this happens much faster than via the top-down system typically used to introduce new rules.”