Online Program

Clinical decision support (CDS) systems in eye and vision care

Tuesday, November 5, 2013 : 1:00 p.m. - 1:15 p.m.

Lori L. Grover, OD, PhD, Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD
Clinical decision support (CDS) systems are information technology systems designed to improve clinical decision making. From the health care perspective, CDS refers to a variety of approaches providing clinicians, staff, patients, and others with knowledge and individualized person-specific information. CDS assists clinicians at the point of individual patient care and has important applications for improving population health. Evidence from a systematic review was categorized into four modeled functional areas: administrative, clinical complexity management, cost control, and decision support. The evidence was extracted from peer-reviewed journals, published abstracts, conference presentations, and professional meetings proceedings. Thirty-nine articles met inclusion criteria; the majority were related to diabetes population and telemedicine-related applications. New theoretical methods for estimating treatment thresholds and emerging population risk factors were identified that will ultimately affect physician risk thresholds in managing chronic conditions. Existing strategies/tools for future use include: applications for encoding/exchange of metadata; grading algorithms and other disease/condition-specific differential diagnostic tools; access to eye care-specific evidence via Electronic Health Record (EHR) systems; eye disease and vision condition-specific decision trees and cost-effectiveness models; use of graphical information systems (GIS) for population compliance management; and stakeholder tele-support. These represent a small fraction of CDS applications that can assist in meeting the unique needs of eye care providers and patient populations. Despite the widespread use of CDS systems throughout health care and the increased applications in eye and vision care over the past decade, there remains a limited scope of applications in eye care.

Learning Areas:

Communication and informatics
Public health or related research

Learning Objectives:
Define the role of Clinical Decision Support (CDS) Systems in improving population health and preventing chronic vision impairment. Describe the scope of advanced CDS functionalities and potential for realizing associated outcomes in eye and vision care. Explain current CDS systems specifically employed in optometric and ophthalmologic practice.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: this research reflects work conducted in meeting requirements for my dissertation in health services research and policy, and for advanced certificate training in public health informatics. as a clinician researcher, I have over 20 years experience in the field of vision impairment and rehabilitation
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.