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Clinical Decision Support

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ntaylor

(@ntaylor)

Posts: 79

Estimable Member

Topic starter

Hello,

I work for a multi-specialty group who share the same EMR system. We utilize custom VFE forms and I was wondering if anyone would be willing to share any suggestions and/or VFE code for CDS you are using in your practice for Stage 2 MU. I was hoping to find some suggestion that could apply to multiple specialties. For instance, for stage 1 the CDS that we used checked the blood pressure being entered, and if it was above a certain range, it would generate a popup warning noting that the BP was extremely high and suggesting that they retake the blood pressure to confirm, and gave them direction on what to do if the second reading also came back extremely high.
We were able to use this across all our specialties and was hoping that others had similar suggestions.

thanks in advance.

Posted : December 23, 2014 1:59 pm

swhite

(@sbrooks)

Posts: 84

Trusted Member

The vitals forms from GE have the triangle indicators for highs and lows with ranges. That should count as CDS.
The Test Management form GE built has recommendations for tests based on diagnosis. That should count.
The CPOE A&P has CDS.
The Protocols has CDS.

You could look into building something for OB:
- Routine labs at intake
- Risk assessment at intake
- Maternal Quad between 15-22 weeks
- GTT between 24 - 28 weeks
- RhoGAM if negative at 28 weeks
- Hemoglobin check at 24 - 28 weeks
- hemotocrit chect at 24 - 28 weeks
- group b strep at 36 weeks
- 37 week risk assessment
High Risk alerts built in for delivery between 20 and 36 weeks, babe born less than 2500 grams, and/or babe born at greater than 4500 grams anywhere in the patient's birth history.

Chronic Care form that looks at Asthma, Diabetes, Hypertension.

Pediatrics:
- Birth History at intake
- PKU date entered at intake
- and Lead Screen, MCHAT, HCT, Dental sealant, Vision Test, and Hearining test
Peds Weight indicators might be a good one.

Posted : December 24, 2014 5:21 am

hbias

(@hbias)

Posts: 83

Estimable Member

We are orthopaedic and Rehab medicine, we use if Diabetic- do foot exam, if BMI > xx weight management handout, if smoker, smoking cessation. If BP high recommend follow up with PCP. We also use if fracture diagnosis, do you want x-ray at next visit. All of these but the fracture correlate to CQMs so it is a double win.

Definitely interested in other ideas as well.

Posted : January 21, 2015 4:48 am

Sam

(@sam)

Posts: 371

Honorable Member

How are you integrating or setting the CDS rules to manifest to the end user?

Posted : April 30, 2015 3:53 am

ntaylor

(@ntaylor)

Posts: 79

Estimable Member

Topic starter

For us, one of the CDS we have in place for monitoring the blood pressure, is done with a text component that is part of the Encouter doc template, and it "watches" the BP obsterms, and if they are out of the defined range, it is set to pop up a message to notify the nurse to retake vitals and refer patient to PCP if it is still high.

The other rules we have in place are utilizing protocols. We use the Protocols banner from GE, which has a red message displayed in the banner if any protocols are not met for a patient

Posted : May 4, 2015 9:19 pm

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