Every day, patients and clinicians make health decisions with limited information at hand. Unfortunately, knowledge obtained from evidence-based research, although key to healthcare quality improvement, is often slow to disseminate into clinical practice. One approach to addressing this problem has been to employ clinical decision support (CDS) that delivers the right information, to the right people, in the right formats, through the right channels, at the right times (“The CDS Five Rights”)[i].
Given the trends toward patient-centered care and the availability of decision tools via consumer devices (e.g. smartphones, connected watches, etc.) there are exciting opportunities to put CDS in the hands of patients. Such an approach can empower patients by linking evidence to their patient-generated data, or by informing patients how to they can best align evidence to their own preferences and values. Given the added emphasis on the patient perspective we term this new area of research and development as, Patient-Centered Clinical Decision Support (PCCDS). And for over two years now, this has been our passion at the PCCDS Learning Network.
Funded by the Agency for Healthcare Research and Quality and managed by RTI International, the learning network is working to advance PCCDS that broadens CDS to better incorporate patients’ viewpoints and the ways patients can leverage evidence to inform their own care. As a part of our efforts, we launched the Better Decisions Together special section in eGEMs, AcademyHealth’s open access, peer-reviewed journal, to showcase innovative health services research in this area.
As the Principal Investigator of the learning network I have the benefit of tracking what is going on in the CDS world and associated developments in PCCDS. For example, I recently attended the Health Information Management Systems Society (HIMSS) conference and was amazed at the Renaissance of interest in CDS, much of it centering on new artificial intelligence (AI) and machine learning technologies that can extract actionable knowledge directly from large data sets. There is also a renewed focus on advanced smart devices and patient-generated data via smart phones, fitness devices, and dedicated healthcare appliances such as glucometers and blood pressure cuffs These exciting technologies not only open new horizons for CDS, they open up a world of potential solutions that can be delivered directly to patients via PCCDS. These make for exciting times in the PCCDS arena!
The momentum continues this week as Health Datapalooza brings together a diverse community of big thinkers and problem solvers who share a mission to liberate and use data to improve health and health care. For instance, one of the issues covered at the meeting will be “Smart Data to Support Clinical Decision Making.” During this session, a panel of experts will discuss the use of machine learning and predictive analytics techniques to predict outcomes, the role of AI in processing physicians’ notes for CDS, and developing of a national infrastructure for sharing computerized CDS. I am looking forward to this and other sessions so that I can promote the need to advance these capabilities directly to patients via PCCDS.
For those working within the area of PCCDS, or CDS for patients, or other areas of health services research that addresses technology and patient decision-making, please consider contributing your work to Better Decisions Together. We also welcome your involvement in The Learning Network by becoming a member for free. Together we can make sure valuable research findings are incorporated into CDS, resulting in better health and health care for everyone.
[i] Osheroff, J.A., Teich, J.A., D. Levick et al. Improving Outcomes with Clinical Decision Support: An Implementer’s Guide. 2nd Edition. Chicago, IL: HIMSS, 2012: p. 15.