Implementation of Clinical Decision Support Systems for Cardiovascular Diseases

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Table of Contents

Introduction
Cardiovascular Diseases
Computerized Provider Order Entry (CPOE)
Implementation and Benefits of Clinical Decision Support Systems (CDSS)
Conclusion
References

Introduction

Nowadays, the efficient work of any reliable health care organization is impossible without implemented electronic systems. Electronic health records (EHRs) systematize all data concerning patients. However, it is Clinical Decision Support Systems (CDSSs) on the basis of Computerized Provider Order Entry (CPOE) that provides accurate and correct actions of clinicians. In this essay, the operational features and benefits from the implementation of CDSSs in the work of the department that is occupied with cardiovascular diseases are described.

Cardiovascular Diseases

Cardiovascular diseases (CVDs) are defined as a specific group of disorders connected with the functioning of blood vessels and the heart. The person’s problems within the heart and vascular system may include congenital birth defects and issues acquired in the course of a lifetime. They are regarded as the most disturbing health issues as CVDs are the main cause of death all over the world (World Health Organization, 2017). More people die every year from CVDs in comparison with any other diseases (World Health Organization, 2017). This group of disorders includes coronary heart disease, peripheral arterial disease, congenital heart disease, cerebrovascular disease, rheumatic heart disease, pulmonary embolism, and deep vein thrombosis. The main difference between these diseases consists in the location of affected blood vessels.

CVDs are traditionally characterized by strokes and heart attacks, and these acute events are primarily caused by the existence of blood blockage. It cannot flow to the brain and heart in the normal way frequently due to “a build-up of fatty deposits on the inner walls of the blood vessels” (World Health Organization, 2017, para. 3). Blood clots and bleeding from the brain blood vessels are common reasons for strokes as well. CVs are typically caused by genetics and the combination of factors that increases the risk of heart and blood vessel disorders, such as tobacco and alcohol use, physical inactivity, an unhealthy diet that leads to obesity, hypertension, hyperlipidemia, and diabetes.

The treatment of CVDs includes diagnostics, analyses, medical intervention, lifestyle change, and specific medications prescribed by health care specialists. The major types of cardiovascular medications include anticoagulants, ACE inhibitors, angiotensin II receptor blockers, antiplatelet agents and dual antiplatelet therapy, beta-blockers, angiotensin receptor-neprilysin inhibitors, calcium channel blockers, digitalis preparations, vasodilators, diuretics, and cholesterol-lowering medications (American Heart Association, n.d.). However, in case of hospitalization due to a stroke or heart attack, all necessary treatment and the prescription of medications should be conducted and controlled by the hospital physician.

Computerized Provider Order Entry (CPOE)

Computerized Provider Order Entry, also known as Computerized Physician Order Entry or Computerized Practitioner Order Entry, is an electronic process of sending treatment instructions and medication orders to medical professionals. The process is designed and implemented in a computer application, and such a format is highly beneficial as it helps to exclude errors that may be related to the ambiguity of the medical orders’ transcription or handwriting. CPOE is integrated with electronic health records (EHRs) and Clinical Decision Support Systems (CDSSs). It subsequently optimizes the effectiveness of health care delivery and patient safety by reducing medication errors.

In addition, CPOEs contribute to the efficiency of medical assistance through the timely distribution of orders between the hospital’s departments or facilities. Moreover, the process may highlight orders that require preapproval from insurance programs to reduce the returns on initially denied claims. It goes without saying that specific incidents may occur in the work of CDSSs, such as information loss or communication breakdown. Data loss may be prevented by the copying of the patients’ information on portable data storage devices or paper and adjusted by IT specialists. Communication breakdown between health care providers in CDSSs may be negotiated through face-to-face contact.

The system of CPOE was designed to copy the paper chart workflow, and it is currently used in conjunction with e-prescribing systems that inform clinicians about current medications and drug allergies of a particular patient. While CPOEs were formerly sold as separate systems, the majority of EHR products are currently equipped with the modules of CPOEs. They allow physicians to put patient data electronically in drop-down menus and text boxed instead of handwriting notes.

Implementation and Benefits of Clinical Decision Support Systems (CDSS)

Clinical Decision Support Systems are electronic programs that analyze patient data within EHRs to help physicians and other health care specialists implement appropriate evidence-based clinical guidelines through the sending of reminders and prompts. The design and implementation of CDSSs are immeasurably significant for the treatment of cardiovascular disorders in health care organizations, especially with a large number of patients who need specific timely and accurate treatment. Systems may be used to remind health care providers to screen for the risk of any cardiovascular disease, stroke, or heart attacks, such as diabetes, blood pressure, and high cholesterol (Community Preventive Services Task Force, 2014). They flag all cases of hyperlipidemia or hypertension and provide treatment protocol information as well.

CDSSs are extremely helpful for control over the prescription of medicine and medication adherence as well. In addition, systems analysis and helps to identify the patients’ risk for the diseases’ development on the basis of their medical history, clinical test results, and current observable symptoms (Community Preventive Services Task Force, 2015). They provide recommendations for the patients’ health behavior changes such as physical activity, quitting smoking, and a well-balanced diet.

Integrated with a CPOE, CDSSs provide the electronic administration of medication to eliminate the risk of an error in the patients’ specific cases. For instance, if a patient has an allergy to certain medication, like angiotensin II receptor blockers, that has been chosen by a health care provider, the system will analyze the patient’s data and information that this person is allergic (Saxena, Lung, & Becker, 2011). This function of CDSSs is highly beneficial for the prevention of medication errors. Moreover, the use of CDSSs contributes to the improvement of patient safety as it provides efficient cooperation between an attending physician and a nurse who will take care of a patient. Clinical Decision Support System provides the ability for a specialist to put orders for a nurse without verbal conversation for continuous follow-up. Due to CDSS, a nurse may quickly implement the physician’s orders without delays in health care delivery. In addition, CDSSs support the awareness of health care providers with the help of a health maintenance section that includes the reminders of actions that were done and should be done in the future. For instance, all reminders may be situated in the system’s bright yellow box.

Conclusion

CDSSs are defined as electronic programs that analyze patient data within EHRs to assist health care providers in implementing appropriate evidence-based clinical guidelines and making decisions concerning treatment planning. Integrated with a CPOE, these systems send notifications to physicians concerning the patients’ peculiarities to correct medication and exclude errors, and reminders of actions that were done and should be done in the future. CDSSs contribute to effective health care delivery by nurses as they provide physicians with the ability to set orders and stay connected with nursing workers electronically. The implementation of CDSSs is immeasurably significant for the treatment of cardiovascular disorders in health care organizations. They remind professionals to screen for the risk of cardiovascular diseases, flag all cases of hyperlipidemia or hypertension, provide treatment protocol information, and help to control the prescription of medicine and medication adherence.

References

American Heart Association. (n.d.). Cardiac medications. Web.

Community Preventive Services Task Force. (2014). Cardiovascular disease prevention and control: Clinical Decision-Support Systems (CDSS). [PDF file]. Web.

Community Preventive Services Task Force. (2015). Clinical Decision Support Systems are recommended to prevent cardiovascular disease. American Journal of Preventive Medicine, 49(5), 796-799.

Saxena, K., Lung, B. R., & Becker, J. R. (2011). Improving patient safety by modifying provider ordering behavior using alerts (CDSS) in CPOE system. AMIA Annual Symposium Proceedings Archive, 2011, 1207-1216.

World Health Organization. (2017). Cardiovascular diseases (CVDs).Web.

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