Clinical decision support tools help doctors provide better care

We developed a clinical decision support (CDS) system that clinicians use to help identify health care priorities so they can discuss evidence-based treatment options with patients.

We are pioneers in developing, implementing and evaluating CDS that is integrated with the electronic health record and used to support patient care. We develop and maintain clinical algorithms that identify health risks and multiple medical conditions and give treatment suggestions and reminders for patients and clinicians to consider. The algorithms are maintained within a web service and are quickly updated as new evidence emerges and clinical guidelines change. The CDS system provides up-to-date, actionable health information to clinicians and patients as a foundation for personalized and patient-centered medicine.

We have received more than $30 million in federal research awards since 2004 for the development of CDS related to diabetes, heart disease risk reduction, prediabetes, serious mental illness, opioid use disorder, cancer prevention, high blood pressure in teens and tobacco use in dental patients.

The purpose of clinical decision support projects is to:

Identify and target patients with high-risk conditions
Prioritize risk factors based on potential benefits to the individual
Help patients and clinicians make more informed decisions
Quickly move new evidence and guidelines into practice
Improve outcomes for people with chronic conditions
Show value and cost-effectiveness
Improve clinician efficiency and the patient experience

Learn about our Center for Chronic Care Innovation.

Investigators

Key projects

A Team-Based and Technology-Driven Adherence Intervention to Improve Chronic Disease Outcome

This project will develop, implement and test a care process to help patients with medication nonadherence by improving identification of the problem, increasing patient involvement in medication decision making and integrating pharmacists within the primary care team.

A Technology-Driven Intervention to Improve Identification and Management of Chronic Kidney Disease in Primary Care

This project will develop and test a strategy to improve outcomes for people with chronic kidney disease through earlier recognition, better management of blood pressure and blood sugar and more timely referral to kidney specialists when appropriate.

Clinic-randomized Trial of Clinical Decision Support for Opioid Use Disorders in Medical Settings (COMPUTE 2.0)

We developed and piloted a web-based and electronic health record-integrated clinical decision support tool to guide primary care providers on the diagnosis and treatment of opioid use disorder. In this study, we will implement the tool in a large, multisite, clinic-randomized controlled trial to evaluate its effect on practice process measures and patient outcomes.

Reducing Clinical Inertia in Diabetes Care

We developed and implemented a diabetes CDS tool through a clinic-randomized trial. It showed improved glucose and blood pressure control for patients.

Prioritized Clinical Decision Support to Reduce Cardiovascular Risk

This clinic-randomized trial showed a reduced 10-year risk of a heart attack or stroke through the use of a CDS system called CV (cardiovascular) Wizard.

Can the CV Wizard Tool Impact Guideline-based Cardiovascular Disease Care in the Safety Net?

This project will spread CV Wizard CDS to safety net community health centers in 14 states. The goal is to improve heart disease risk factor control in low-income, racially and ethnically diverse Americans.

A Randomized Clinical Trial to Reduce Cardiovascular Risk in Adults with Serious Mental Illness (SMI)

Patients with SMI die, on average, 20 years earlier than their peers mostly due to heart disease. This project uses a CDS system to identify and target patients with SMI to help lower their risk for heart attacks and strokes.

Reducing Cardiovascular Risk in Prediabetes Patients Using Electronic Health Record-Based Decision Support.

We will test a CDS system designed to identify and target patients with prediabetes in a rural health system to lower their risk for heart attacks and strokes.

Implementing Cancer Prevention Using Patient-Clinician Clinical Decision Support

We will test a new version of the CDS system that adds evidence-based recommendations for breast, colon, lung, cervical cancer screening and prevention in a rural health system.

Key publications

Gilmer TG, et al. Cost effectiveness of an electronic medical record based clinical decision support system. Health Services Research
Kharbanda EO, et al. Development and piloting of an EHR-linked clinical decision support system to improve recognition of hypertension in adolescents. EGEMS (Wash DC)
O’Connor PJ, et al. Current status and future directions for electronic point-of-care clinical decision support to improve diabetes management in primary care. Diabetes Technology & Therapeutics
O’Connor PJ, et al. Current status and future prospects for electronic point-of-care clinical decision support in diabetes care. Current Diabetes Reports
O’Connor PJ, et al. Impact of electronic health record clinical decision support on diabetes care: a randomized trial. Annals of Family Medicine
Sperl-Hillen JM, et al. Clinical decision support directed to primary care patients and providers reduces cardiovascular risk: A randomized trial. Journal of the American Medical Informatics Association
Sperl-Hillen JM, et al. Outpatient EHR-based diabetes clinical decision support that works: lessons learned from implementing Diabetes Wizard. Diabetes Spectrum

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