Abstract
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For cancer care, a clinical decision support system (CDS) is designed to deliver, electronically, patient-specific information to advise, not replace, a doctor's own clinical recommendations. In today's world, it is simply not possible for clinicians to keep up with the dizzying pace of new, potentially actionable, published discoveries in the field.
That is one challenge a clinical decision support solves. A good CDS is constantly updating its knowledge with new data from a host of journal publications, and other public and open data sources, to provide clinical guidance based on the most up-to-date research available.
Caring for oncology patients is complex, requiring participation from multiple specialties and primary care physicians. A CDS can help a clinical team manage the patient journey to ensure they are getting the best care, based on the best knowledge available.
Given this, oncology clinical decision support is still in its early stage of being implemented across health systems in the U.S. But the need is critical. A report providing an overview of CDS systems published in April 2009 in the Journal of the National Comprehensive Cancer Network, noted that “CDS systems have the potential to significantly improve cancer care delivery, but there are critical gaps in the availability and use of effective CDS tools.”
Some of these gaps can be solved by CDS vendors adding functionality to enhance their offerings, especially tools that includes a patient's molecular information along with the clinical information contained in the electronic health record. Such tools could be as straightforward as providing ordering physicians with information about what molecular diagnostic should be ordered for a specific patient, who offers the test, and whether or not the test is reimbursed by their payer. It might also provide information about how to monitor the patient once their therapy has begun and whether their disease, and the drug chosen to treat it, may require additional testing and follow up.
Despite some gaps, there is a growing body of evidence of the value of a CDS in the hospital setting. An April 2019 study in the Annals of Oncology of CDS systems used to inform care of a small set of lung cancer patients indicated that the care team agreed with the CDS' treatment recommendations in 18 cases (78.3%) and partly for 4 (17.4%). Other findings showed that clinicians saved time by using the CDS (73.9%) and, notably, that guidance provided by the CDS impacted the treatment decision in more than 39% of cases.
Based on their experience, more than 95% of the physicians using the system strongly agreed or agreed that the CDS system provided relevant information that was easy to understand, and was actionable.
