Sapna Sharma


September 2008

Document Type


Degree Name



Dept. of Medical Informatics and Clinical Epidemiology


Oregon Health & Science University


Clinical decision support systems (CDSS) are computer programs that respond to user activity. They assist clinicians and other health professionals in making better decisions. These systems are used to improve the overall quality of health care. They have helped reduce the cost, prevent errors, save time, and give better end results. i Clinical decision support systems are efficient in delivering medical data, hence promoting patient safety, but function differently because of the different designs, definitions, rules, software algorithms, and models they are based on. There is no easy way to group these decision support systems into one common workflow or process. There is a growing need to develop a standard which compares the effectiveness of the various clinical decision support systems. In this project we developedfa common standard or fomat that can be used to measure the commonalities of the functionalities of multiple decision support systems. This was achieved by evaluating the 42 different 'actions' that are common to various CDSS. The functionalities of 10 different decision support systems were compared. A template was created for better analysis of the data gathered on these 42 actions. These actions were divided into four categories: triggers, data elements, interventions, and offered choices. The data collection was done through an interview process. All systems were evaluated in depth for the decision support capabilities they use. The 'Triggers' category consisted of 9 questions, the 'Input data elements' category consisted of 14 questions, the 'Interventions' category consisted of 7 questions and the 'Offered choices' category consisted of 12 questions. So the total number of questions created for all four categories was 42. The data collected by the interviews was analyzed and the clinical decision support systems were compared. The comparison was done according to categories and it was seen in every category some systems faired worse than others and others faired good. The study shows that within each category there are differences in the functionalities of the systems. Especially System 6 and 7 are fairing worse across all categories. The study though does not yet tell us what this lack of functionalities means.




School of Medicine



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