Advanced Clinical Decision Support and the Road to Clinical Effectiveness

Monday, March 13, 2017

Over the last several decades, clinical decision support solutions have demonstrated success in helping improve quality of care in the American healthcare system. But the need to “broaden that impact” has led professionals to consider a more holistic approach to decision support that takes into account patient engagement, consistency of care, and the ability to measure improvements in outcomes.

Wolters Kluwer recently announced its new Advanced Clinical Decision Support (ACDS) solution with a video detailing its development plan. ACDS is an integrated solution that helps healthcare organizations become more clinically effective through:

  1. Clinical decision support
  2. Patient engagement / shared decision making
  3. Personalized medication education for both clinicians and patients
  4. Measurement quantifying both impact and quality

“In 2015, we spent more than $3.2 trillion (on healthcare) in the U.S., which is more than the gross domestic product of France,” said Dr. Peter Bonis, chief medical officer of Wolters Kluwer Clinical Effectiveness in a recent podcast on “The Road to Clinical Effectiveness.” And studies have shown that 30% of that spend is wasteful.

If healthcare spending continues at its current pace, increasing by 5.8% per year, it will represent 20% of total economy by 2025, Bonis added. That would outpace the rate with which the U.S. GDP is growing and force healthcare premiums and deductibles to rise.

“This is not sustainable,” he said. “Healthcare’s simply unaffordable, and if we’re going to manage to insure everyone across the nation, we really have to pay attention to that cost-quality equation. There’s only so much that can be done in optimizing revenue and containing cost within the healthcare delivery system.” The focus has to shift to quality and to optimizing and improving clinical decision making, he said.

Bonis was joined on the podcast by Wolters Kluwer Clinical Effectiveness CEO, Dr. Denise Basow, who agreed, noting that “we have to get to the point where we’re all achieving clinical effectiveness if we truly want to begin to address this cost-quality equation.”

ACDS seeks to address many of the problems Basow and Bonis identify in the podcast:

Clinical Decision Support (CDS)

Bonis explained that care varies based on where a patient is geographically and with which doctor and healthcare system he or she ends up. It shouldn’t be up to chance, he asserts, when there’s evidence supporting specific best practices and treatment plans that should be used consistently throughout the healthcare landscape.

The “frustrating thing,” Basow added, is that professionals have been discussing and studying variability in care since the 1970s. Now, after 40 years, Bonis said advances in technology and knowledge put us in better position to tackle this issue.

CDS provides practitioners with critical information in the appropriate workflow at the point of care. Developing CDS with a greater ability to consider context, appropriate use, and individual parameters will continue to help improve care quality and order appropriateness, helping to reduce errors and standardize care.

Engagement and Education

Healthcare is experiencing a global shift to viewing patients “as center of the healthcare universe,” Basow said. Patient preference impacts care choice, so the patient needs to be educated on his or her condition and options. But even before those decisions are made, Basow explained, patients need to feel fully engaged in their healthcare, so they understand the need to undergo preventative screenings and routine follow-up.

Solutions that facilitate clinician-patient communication, support treatment adherence, and empower patients to take appropriate action are key to engagement. Additionally, the resources provided to patients need to simplify complex medical issues and help manage their expectations.

Professionals also need to continue to engage with education on care management decisions to help improve quality and standardization.


“It’s not that providers don’t want to provide the best care, it’s sometimes they don’t recognize that they aren’t providing the best care,” Basow explained. Modern integrated technology solutions measure data at both the individual and population level to help identify problems and assess outcomes.

Healthcare organizations need solutions that provide access to usage data, as well as drug pricing data to help analyze spend and purchasing decisions.

To learn more:

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