View source for Improving pathway compliance and clinician performance by using information technology

== Objective==

To deliver patient-specific advice at the time and place of consult and thereby improving clinician performance, the authors used [[CDS|computer-based decision support]] into the clinical workflow. 

== Abstract ==

It has been proven that [[Medication errors|errors in medicine]] are not rare, may be even fatal and one of the major reasons cited is the cognitive overload of clinicians. [[EBM|Evidence-based clinical guidelines]] can help reduce these errors if implemented correctly. The authors feel that this is possible if the guidelines are integrated in the clinical workflow/pathways which would in turn improve clinician performance and guideline adherence. The authors under took this task by studying the care process for patients with proximal femoral fracture at the Department of Trauma, re-constructive and hand surgery at the Marburg University Medical Center.

A prospective study on 168 patients with 1 year follow-up was carried out. A target clinical pathway was detailed out with the core parts highlighted where computer-based decision support could be used. The IT infrastructure consisted of a development of a [[EMR|Health Information System]] on the basis of a commercially available product and a Computer aided software engineering tool which would reuse the data from the central database. The application consisted of 10 forms for [[structured data entry]] and decision support. Patient –specific information was given by highlighted choices of medication and deviation from pathway was an option but with variance documentation.

== Comments ==

The authors have tried to integrate and implement key factors like decision support and evidence-based guidelines to the clinical workflow in a Trauma unit of a University Medical center. Clinicians could use the recommendations to provide evidence-based decision making at the time of care. User acceptance and [[usability]] will be keys to its success. The challenge would be to use this application  for more complex disease processes.

[[Category: OHSU-F-06]]
[[Category: Reviews]]