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Clinical Decision Support Systems (CDSSs) and their applications in daily clinical practice and CAREPATH project
Published on 26 October 2022

Decision making is a fundamental and important part of patient care and treatment process. Making the right decisions at the right time and in the right place is always crucial in clinical practice and can result in added value in patient outcome and disease management. To improve the quality of clinical decisions, correct and complete data should be provided, analyzed and processed scientifically, based on accurate and up-to-date evidences at the time of decision making. That is where CDSSs can provide an added value in the clinical setting.

Are CDSSs new in healthcare?

Although the idea behind any decision support systems was proposed decades ago, the concept is gaining increasing popularity in recent years. CDSSs have been used in healthcare more than four decades ago, but the increasing number of CDSSs both in research and practice is the result of drivers and demand pulls and pushes in the community.

For example, the increasing amount of knowledge and evidence released has made finding, retrieving, collecting and validating the data a very complex and time-consuming process.

The limitation and lack of resources, especially human resources, in the health system also limits the evidence and time to use by the healthcare teams. Under these circumstances, providing a system that can facilitate the process of data retrieval, analysis and inference based on the best practice recommendations could be very helpful.

Other drivers of CDSS usage such as increased computer literacy and acquiring of necessary skills of using information and communication technology and its derivatives have also resulted in popularity and acceptance of CDSSs in healthcare systems.

There are also some pushing drivers that facilitate the process of CDSS implementation and application. For example, the availability of ICT infrastructure and facilities has made implementing CDSSs possible, easy and relatively inexpensive. The existence of cheap, powerful and accessible data storage, management, recovery and analysis tools, in addition to internet, web and cloud technologies, made the design and implementation of all these components facilitated, cost-effective and simply possible. With electronic health records (EHR) in place and enormous improvements in computers’ capacities and analytical capabilities, CDSSs are becoming an inevitable tool in health settings that intend to provide highest standards of health service to their patients. CDSSs analyze data within EHRs to provide alerts and reminders to assist health care providers in benefiting from the existing and approved clinical guidelines at the point of care.

What are the benefits of CDSSs?

It is believed that CDSSs can improve health outcome of patients through increased quality of care, reduced errors and adverse events, improved efficiency, increased healthcare and patient satisfaction and ameliorated patient safety.

Are there any limitations in using CDSSs?

Like any other system, CDSSs have their own disadvantages and limitations. For example, some healthcare providers might have a sense of losing their autonomy. CDSS alerts can cause fatigue and reduce much needed focus and concentration. It can also change the workflow in the healthcare setting and increase EHR usage.

How do we benefit from CDSSs in CAREPATH project?

In CAREPATH, CDSS module provides decision support aids by suggesting treatments, risk assessments and guidance about polypharmacy management and other complex situations. CDSS will also be utilized by Adaptive Integrated Clinical Practice (AICP) during the development and updating the care plans. The CDSS module includes an Early Warning System (EWS), utilizing algorithms built by machine learning techniques to identify potentially preventable hazards.

In this project, consortium partners build clinical decision support services to deliver personalized guidance to healthcare professionals about the goals and interventions (treatment actions, patient monitoring activities and lifestyle management activities). These suggestions can be added to the ongoing care plan of the patient according to the recommendations of the clinical guidelines to achieve a patient-centered customized care. The exact content of CDSS implemented in CAREPATH depends on the holistic patient-centered CAREPATH best practice guideline which is going to be developed through the joint collaboration of clinical and technical partners.

  1. Bilici, E., S. N. L. C. Keung, G. Despotou and T. N. Arvanitis (2017). Computer-interpretable Guidelines driven Clinical Decision Support Systems: An Approach to the Treatment Personalisation Routes of Patients with Multi-Diseases, WIN.
  2. Muhiyaddin, R., A. A. Abd-Alrazaq, M. Househ, T. Alam and Z. Shah (2020). "The impact of clinical decision support systems (CDSS) on physicians: a scoping review." The Importance of Health Informatics in Public Health during a Pandemic: 470-473.
  3. Pournik, O., B. Ahmad, S. N. Lim Choi Keung, O. Khan, G. Despotou, A. Consoli, J. Ayadi, L. Gilardi, G. B. Laleci Erturkmen and M. Yuksel (2022). CAREPATH: Developing Digital