Benefits of Clinical Decision Support Systems for the Management of Noncommunicable Chronic Diseases: Targeted Literature Review
BackgroundClinical decision support systems (CDSSs) are designed to assist in health care delivery by supporting medical practice with clinical knowledge, patient information, and other relevant types of health information. CDSSs are integral parts of health care technologies...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2024-11-01
|
| Series: | Interactive Journal of Medical Research |
| Online Access: | https://www.i-jmr.org/2024/1/e58036 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846151330980167680 |
|---|---|
| author | Klaudia Grechuta Pedram Shokouh Ahmad Alhussein Dirk Müller-Wieland Juliane Meyerhoff Jeremy Gilbert Sneha Purushotham Catherine Rolland |
| author_facet | Klaudia Grechuta Pedram Shokouh Ahmad Alhussein Dirk Müller-Wieland Juliane Meyerhoff Jeremy Gilbert Sneha Purushotham Catherine Rolland |
| author_sort | Klaudia Grechuta |
| collection | DOAJ |
| description |
BackgroundClinical decision support systems (CDSSs) are designed to assist in health care delivery by supporting medical practice with clinical knowledge, patient information, and other relevant types of health information. CDSSs are integral parts of health care technologies assisting in disease management, including diagnosis, treatment, and monitoring. While electronic medical records (EMRs) serve as data repositories, CDSSs are used to assist clinicians in providing personalized, context-specific recommendations derived by comparing individual patient data to evidence-based guidelines.
ObjectiveThis targeted literature review (TLR) aimed to identify characteristics and features of both stand-alone and EMR-integrated CDSSs that influence their outcomes and benefits based on published scientific literature.
MethodsA TLR was conducted using the Embase, MEDLINE, and Cochrane databases to identify data on CDSSs published in a 10-year frame (2012-2022). Studies on computerized, guideline-based CDSSs used by health care practitioners with a focus on chronic disease areas and reporting outcomes for CDSS utilization were eligible for inclusion.
ResultsA total of 49 publications were included in the TLR. Studies predominantly reported on EMR-integrated CDSSs (ie, connected to an EMR database; n=32, 65%). The implementation of CDSSs varied globally, with substantial utilization in the United States and within the domain of cardio-renal-metabolic diseases. CDSSs were found to positively impact “quality assurance” (n=35, 69%) and provide “clinical benefits” (n=20, 41%), compared to usual care. Among CDSS features, treatment guidance and flagging were consistently reported as the most frequent elements for enhancing health care, followed by risk level estimation, diagnosis, education, and data export. The effectiveness of a CDSS was evaluated most frequently in primary care settings (n=34, 69%) across cardio-renal-metabolic disease areas (n=32, 65%), especially in diabetes (n=13, 26%). Studies reported CDSSs to be commonly used by a mixed group (n=27, 55%) of users including physicians, specialists, nurses or nurse practitioners, and allied health care professionals.
ConclusionsOverall, both EMR-integrated and stand-alone CDSSs showed positive results, suggesting their benefits to health care providers and potential for successful adoption. Flagging and treatment recommendation features were commonly used in CDSSs to improve patient care; other features such as risk level estimation, diagnosis, education, and data export were tailored to specific requirements and collectively contributed to the effectiveness of health care delivery. While this TLR demonstrated that both stand-alone and EMR-integrated CDSSs were successful in achieving clinical outcomes, the heterogeneity of included studies reflects the evolving nature of this research area, underscoring the need for further longitudinal studies to elucidate aspects that may impact their adoption in real-world scenarios. |
| format | Article |
| id | doaj-art-62905d2eb84c4a9fa2895f6fee0b55a0 |
| institution | Kabale University |
| issn | 1929-073X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Interactive Journal of Medical Research |
| spelling | doaj-art-62905d2eb84c4a9fa2895f6fee0b55a02024-11-27T14:45:33ZengJMIR PublicationsInteractive Journal of Medical Research1929-073X2024-11-0113e5803610.2196/58036Benefits of Clinical Decision Support Systems for the Management of Noncommunicable Chronic Diseases: Targeted Literature ReviewKlaudia Grechutahttps://orcid.org/0000-0002-4954-1372Pedram Shokouhhttps://orcid.org/0000-0002-4514-0045Ahmad Alhusseinhttps://orcid.org/0000-0003-1000-8308Dirk Müller-Wielandhttps://orcid.org/0000-0002-8807-6442Juliane Meyerhoffhttps://orcid.org/0009-0009-3745-7753Jeremy Gilberthttps://orcid.org/0000-0001-7456-9396Sneha Purushothamhttps://orcid.org/0009-0006-5870-1661Catherine Rollandhttps://orcid.org/0009-0004-6962-2008 BackgroundClinical decision support systems (CDSSs) are designed to assist in health care delivery by supporting medical practice with clinical knowledge, patient information, and other relevant types of health information. CDSSs are integral parts of health care technologies assisting in disease management, including diagnosis, treatment, and monitoring. While electronic medical records (EMRs) serve as data repositories, CDSSs are used to assist clinicians in providing personalized, context-specific recommendations derived by comparing individual patient data to evidence-based guidelines. ObjectiveThis targeted literature review (TLR) aimed to identify characteristics and features of both stand-alone and EMR-integrated CDSSs that influence their outcomes and benefits based on published scientific literature. MethodsA TLR was conducted using the Embase, MEDLINE, and Cochrane databases to identify data on CDSSs published in a 10-year frame (2012-2022). Studies on computerized, guideline-based CDSSs used by health care practitioners with a focus on chronic disease areas and reporting outcomes for CDSS utilization were eligible for inclusion. ResultsA total of 49 publications were included in the TLR. Studies predominantly reported on EMR-integrated CDSSs (ie, connected to an EMR database; n=32, 65%). The implementation of CDSSs varied globally, with substantial utilization in the United States and within the domain of cardio-renal-metabolic diseases. CDSSs were found to positively impact “quality assurance” (n=35, 69%) and provide “clinical benefits” (n=20, 41%), compared to usual care. Among CDSS features, treatment guidance and flagging were consistently reported as the most frequent elements for enhancing health care, followed by risk level estimation, diagnosis, education, and data export. The effectiveness of a CDSS was evaluated most frequently in primary care settings (n=34, 69%) across cardio-renal-metabolic disease areas (n=32, 65%), especially in diabetes (n=13, 26%). Studies reported CDSSs to be commonly used by a mixed group (n=27, 55%) of users including physicians, specialists, nurses or nurse practitioners, and allied health care professionals. ConclusionsOverall, both EMR-integrated and stand-alone CDSSs showed positive results, suggesting their benefits to health care providers and potential for successful adoption. Flagging and treatment recommendation features were commonly used in CDSSs to improve patient care; other features such as risk level estimation, diagnosis, education, and data export were tailored to specific requirements and collectively contributed to the effectiveness of health care delivery. While this TLR demonstrated that both stand-alone and EMR-integrated CDSSs were successful in achieving clinical outcomes, the heterogeneity of included studies reflects the evolving nature of this research area, underscoring the need for further longitudinal studies to elucidate aspects that may impact their adoption in real-world scenarios.https://www.i-jmr.org/2024/1/e58036 |
| spellingShingle | Klaudia Grechuta Pedram Shokouh Ahmad Alhussein Dirk Müller-Wieland Juliane Meyerhoff Jeremy Gilbert Sneha Purushotham Catherine Rolland Benefits of Clinical Decision Support Systems for the Management of Noncommunicable Chronic Diseases: Targeted Literature Review Interactive Journal of Medical Research |
| title | Benefits of Clinical Decision Support Systems for the Management of Noncommunicable Chronic Diseases: Targeted Literature Review |
| title_full | Benefits of Clinical Decision Support Systems for the Management of Noncommunicable Chronic Diseases: Targeted Literature Review |
| title_fullStr | Benefits of Clinical Decision Support Systems for the Management of Noncommunicable Chronic Diseases: Targeted Literature Review |
| title_full_unstemmed | Benefits of Clinical Decision Support Systems for the Management of Noncommunicable Chronic Diseases: Targeted Literature Review |
| title_short | Benefits of Clinical Decision Support Systems for the Management of Noncommunicable Chronic Diseases: Targeted Literature Review |
| title_sort | benefits of clinical decision support systems for the management of noncommunicable chronic diseases targeted literature review |
| url | https://www.i-jmr.org/2024/1/e58036 |
| work_keys_str_mv | AT klaudiagrechuta benefitsofclinicaldecisionsupportsystemsforthemanagementofnoncommunicablechronicdiseasestargetedliteraturereview AT pedramshokouh benefitsofclinicaldecisionsupportsystemsforthemanagementofnoncommunicablechronicdiseasestargetedliteraturereview AT ahmadalhussein benefitsofclinicaldecisionsupportsystemsforthemanagementofnoncommunicablechronicdiseasestargetedliteraturereview AT dirkmullerwieland benefitsofclinicaldecisionsupportsystemsforthemanagementofnoncommunicablechronicdiseasestargetedliteraturereview AT julianemeyerhoff benefitsofclinicaldecisionsupportsystemsforthemanagementofnoncommunicablechronicdiseasestargetedliteraturereview AT jeremygilbert benefitsofclinicaldecisionsupportsystemsforthemanagementofnoncommunicablechronicdiseasestargetedliteraturereview AT snehapurushotham benefitsofclinicaldecisionsupportsystemsforthemanagementofnoncommunicablechronicdiseasestargetedliteraturereview AT catherinerolland benefitsofclinicaldecisionsupportsystemsforthemanagementofnoncommunicablechronicdiseasestargetedliteraturereview |