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


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. 

Coupled with the hassle of meeting advance electronic health record (EHR) platform integration requirements, Dr. Rao proposes that buying knowledge-based CDSS is increasingly more favorable and the way forward. 

A number of major initial and ongoing hurdles with home-grown solutions – including the significant time and effort needed to constantly update evidence – could overwhelm and overburden healthcare organizations, taking time away from delivering standardized and evidence-based care. 

Dr. Rao offers five ways on how these challenges can be avoided with the purchase of third-party CDSS platforms.


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

The 2 part paper: 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 considered when deciding to buy or build such decision support tools


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. 

Coupled with the hassle of meeting advance electronic health record (EHR) platform integration requirements, Dr. Rao proposes that buying knowledge-based CDSS is increasingly more favorable and the way forward. 

A number of major initial and ongoing hurdles with home-grown solutions – including the significant time and effort needed to constantly update evidence – could overwhelm and overburden healthcare organizations, taking time away from delivering standardized and evidence-based care. 

Dr. Rao offers five ways on how these challenges can be avoided with the purchase of third-party CDSS platforms.


Read more »

Health Information Technology: A Longer ROI for Higher ROI? by Dr.Ujjwal Rao @DrUjjwalRao



Recently I gave a talk at the Revolutionizing Healthcare with IT Conference in Mumbai around ROI of Health IT. Here's the gist!

Before I delve any deeper, let’s understand what ROI is.

ROI can mean different things to different people. To nurses and infection control teams, ROI means ‘Risk of Infection’. To most of us burdened by home loans, car loans and education loans, ROI means 'Rate of Interest’. To the CEO who makes gut-wrenching investments and wants to make money back, ROI means ‘Return on Investment’. As for me, the emergency physician in me wants to take ROI at its face value, but the clinical informaticist in me thinks of ROI as the ‘Radius of Information’.

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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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