Clinical Decision Support Systems: Resolving the “Build or Buy” Dilemma - Part 2 by Dr. Ujjwal Rao, @drujjwalrao


The 2 part paper (review part 1 here): Discusses the key role of evidence-adaptive clinical decision support systems (CDSS) in the healthcare system of the future. Weighs the pros and cons that hospitals should consider when deciding to buy or build such decision support tools


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Clinical Decision Support Systems: Resolving the “Build or Buy” Dilemma - Part 1 by Dr. Ujjwal Rao, @drujjwalrao

Healthcare providers today face the challenge of delivering up-to-date, evidence-based care given the ever burgeoning pool of medical evidence, which is not only prone to inconsistencies but also take an average of 17 years to make their way into routine clinical practice. 

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Order Sets: A POKA-YOKE for Clinical Decisions by Dr. Ujjwal Rao, @DrUjjwalRao - Part 2/2

The full potential of a CDSS can be realised when it is seamlessly integrated into the clinical workflow and is evidence-adaptive

In continuation to the the part one of the article, in the part 2 of the "Order Sets: A POKA-YOKE for clinical decisions" Dr. Rao is

ADDRESSING THE KNOWLEDGE GAP THROUGH CDSS:

THE POWER OF ORDER SETS

A “Physician Order” is a communication directing a particular service or action to be taken in the care of a specific patient. Medications, diet, physical activities, laboratory tests, radiologic studies, therapies, treatments...all are among the literally dozens of orders written to guide the care of each and every patient by the physician throughout an ordinary day. 

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Order Sets: A POKA-YOKE for Clinical Decisions by Dr. Ujjwal Rao, @DrUjjwalRao - Part 1/2

Poka (unintended mistake) Yoke (avoid) is the Japanese equivalent for “error proofing”.  
This Lean Manufacturing strategy is more relevant than ever in healthcare today. Why?

FIRST, DO NO HARM
The Supreme Court of India recently ordered one of the largest compensations so far in the country to a girl who lost her vision at birth in a case of medical negligence. The girl, who is now 18 years old, was born prematurely at a government hospital but was discharged from the hospital without a retinopathy test, a must for prematurely born babies. By the time the family discovered the lapse, the girl had lost her vision [1].

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