Responses on the Pros and Cons of Clinical Decision Support System (CDSS)

Reply to the below discussion post below.
Question One
Pros of Clinical Decision Support System (CDSS)
Improving efficiency. The practitioner only has to look in one area to find information needed to diagnose a patient with something. Pieces that are placed together are allergies, labs, radiology, medications, and demographics. There are also support systems that troll the dictation notes and a bill is generated by what information is pulled from this trolling.
Decrease the rate of misdiagnosis. All the information that is obtained is housed in one area, helping to draw a picture of what is going on with a patient. This decreases the incidence of the patient being told they have a diagnosis that is untrue.
Reduce the risk of medication errors. When the EHR is filled out completely, the current list of home medications can be seen. Also, if the patient is allergic to any medications the CDSS will alert the ordering practitioner to verify the order.
Cons of Clinical Decision Support System (CDSS)
Viewed negatively by physicians because it reduces their autonomy. Practitioners now must meet certain criteria for complete documentation. This does not leave the door open for freedom of practicing as the practitioner chooses to. Providers feel like they are being told what to do and what to chart.
Costly to implement, operate, and update. As with any computerized application, it is very costly to implement the program. There are costs acquired with education, and updates that are needed to keep the program running effectively.
Person dependent process to gain knowledge. If the person entering the data does not fully check to ensure that they are documenting the correct patient, then all the information can be incorrect. If the person does not pay attention or understand the pop ups to call attention to a specific piece, then mistakes can be made. If this happens there will be more resources used to help clear up the confusion.
Question Two
Case Study
Patient is a 32-year-old “Jessica Anderson” that went to the clinic for feeling fatigue, shortness of breath and excess menstruation bleeding. Jessica tells the provider that she has a history of excess menstrual bleeding, as well as frequent use of NSAIDS. Patient did not have her ID or insurance card; her reasoning for not having this information is because she has been so tired and cannot think straight. Her vital signs are as follows: Temp 98. Respiratory rate 20. Heart rate 102. Blood pressure is 88/40. Her labs show a hemoglobin of 6.2. Hematocrit of 18. Platelets of 43. Blood type is B+. When the practitioner hears the history and sees the lab work in the computer the plan is now to admit Jessica to the ICU to transfuse blood and monitor blood pressure.
Patient is a direct admit to the ICU. The nurse that put the information into the computer didn’t want to bother the patient by asking her information, so the nurse just used what was put in in the clinic. Lab personnel began to process the orders. They are alerted by the computer system that the blood screening for some reason has an error. The warning is read by the lab staff and taken seriously. The NP is updated due to the warning. The other detail that is relayed to the NP is that the patient just one year before this patient’s blood type was A-. Jessica’s husband and her verifies that his wife’s blood type is A-, not the B+ that is now being reported. The provider is phoned to help with clarity. The Husband has brought patient’s ID and insurance information. It is then discovered that the patient that was registered is the wrong Jessica Anderson, which is a common name in North Dakota. The month and year of birth are the same, however the day is different.
While nurse practitioners (NPs) are increasingly called upon to play a crucial role in improving the healthcare provided to the population, little is known about the nature, extent and outcomes of their involvement and experience with Artificial Intelligence Health Technologies or AIHT (Raymond et al., 2022). This scenario shows that ensuring correctness should be important to all who encounter the patient. One strategy for improvement has been to place greater emphasis on the prevention and monitoring roles played by primary care physicians (PCPs) and other healthcare professionals, especially nurses (Chavez et al., 2017Links to an external site.).
References:
Chavez, K. S., Dwyer, A. A., & Ramelet, A.-S. (2017). International practice settings, interventions, and outcomes of nurse practitioners in geriatric care: A scoping review. International Journal of Nursing Studies. https://doi(dot)org/10.1016/ ijnurstu.2017.09.010, 1-15
Raymond, L., Castonguay, A., Doyon, O., & Paré, G. (2022). Nurse practitioners’ involvement and experience with AI-based health technologies: A systematic review. Applied Nursing Research, 66, N.PAG. https://doi-org(dot)ezproxy(dot)minotstateu(dot)edu/10.1016/j.apnr.2022.151604