By Dhaval Shah
We live in a historic and wonderful time, one in which the volume of medical knowledge doubles, by some estimates, every 73 days - not 50 years as it did in the 1950s.
Simultaneously, patient-centric delivery models, from personalized medicine to value-based care, require clinicians to address the myriad factors that directly and indirectly impact outcomes for individual patients – an endeavor that requires continual access to actionable data.
In the face of this reality, even the most astute caregivers struggle to make decisions that reflect accepted standards of care, benchmarks that notably continue to rapidly change as new innovations and procedures make many protocols obsolete. Simultaneously, clinical teams are stretched thin, with physician and nurse burnout now a significant issue worldwide.
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It is a problem that shows no signs of abating with only 47% of nurses saying they plan to remain in their current job over the next two years. Moreover, nine out of ten nurses are reporting that high patient loads negatively impact patient care and 75% of respondents in the same survey said that their patient loads are unsafe. The situation for physicians is not much better with the overall prevalence of burnout among doctors exceeding 60% in 2021.
Ironically, despite being created to help address many of the issues that increase burnout - among them, the demands of patient care - today’s clinical decision support (CDS) tools often exacerbate the problem. Legacy CDSS systems were created with the expectation that they would make physicians’ lives easier by recommending treatment plans and the steps that comprise them, diagnostic tests, therapies, medicines and doses, and of course, steps to take in the event of problematic developments that cause concern. Unfortunately, few standalone CDSS deliver on this promise.
Many standalone systems draw on isolated databases and data sets. Inaccurate information and algorithms that do not reflect new standards of care are but one cause of adoption issues, with many physicians giving up on such systems after using them just a few times. Alert fatigue is also a significant, yet necessary hindrance in a time when many CDSS are used for dosing error checks.
Most importantly, mistakes that an effective decision support system could theoretically prevent are being made with painful regularity. A recent study found nearly one-in-four patients experienced at least one adverse event while hospitalized. And nearly one-third of these resulted in serious harm that required a prolonged recovery.