Reducing Medical Errors with Help from CDS

Farrell Pierson, MD

If medical error was a disease, it would rank as the third leading cause of death in the United States, according to a recent report in the British Medical Journal earlier this year. The problem may well be even worse, if deaths in non-hospital settings were factored into the calculations. The analysis published in BMJ by Makary et al* focused on inpatient deaths, applying the rate of death from medical error reported in varied studies over the past 17 years.

Time pressure on clinicians and the fragmented state of some electronic health records (EHR) are likely contributing factors to the rate of medical error in the U.S. The reality is that our patients typically are seen in multiple locations, take multiple medications and receive multiple treatments for their multiple ailments.

But while physicians may dream of higher reimbursements for patient visits and an EHR system that works as seamlessly as our ATM networks, we’d best use the tools at hand to safeguard our patients, for we are about to be held accountable for quality outcomes which may result in lower reimbursements, if we don’t increase the quality of the care we provide.

Your EHR’s Clinical Decision Support is such a tool.

The right actions at the right time

Done right, Clinical Decision Support (CDS) automatically:

  • Detects potential adverse medication interactions.
  • Defines what orders are due based on previous lab results for patients with chronic diseases like diabetes, hyperlipidemia, coronary disease, hypertension and renal disease.
  • Prompts you to consider treatment based on test results or other criteria, even before a condition is on a patient’s problem list (such as starting medication for patients at risk for coronary artery disease, based on LDL/HDL values).

These are just 3 examples of the role of CDS in clinical practice. We can’t eliminate human error. But we can use technology to support patient safety and optimal medical care.

How are you using Clinical Decision Support in your practice? Post a comment and share how it’s working for you.

* BMJ 2016;353:i2139

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