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Ten Principles for Effective Clinical Decision Support: Enhancing Evidence-Based Medicine

This article outlines ten key principles designed to improve clinical decision support (CDS) systems, making evidence-based medicine a practical reality in healthcare. It discusses the challenges of knowledge lag, gaps between optimal and actual practice, and the importance of integrating computer-based support into clinical workflows. Key recommendations include ensuring low response times, anticipating physician needs, providing real-time context, and maintaining a user-friendly interface. By incorporating these principles, healthcare systems can enhance their CDS capabilities, ultimately improving patient outcomes and clinical efficiency.

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Ten Principles for Effective Clinical Decision Support: Enhancing Evidence-Based Medicine

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  1. Ten Commandments for Effective Clinical Decision Support:Making the Practice of Evidence-based Medicine a Reality JAMIA, Volume 10, Number 6, Nov/Dec 2003

  2. Introduksjon Kontekst & motivasjon for artikkel • ”Evidence-based Medicine” • ”Knowledge lag & Guidelines” • ”Gap – Optimal vs Actual Practice” • ”Computer-based Clinical Decision Support” Initielle ”decision support” forslag • Advarsler og medisineringsstøtte > diagnoseassistanse, men hvordan?

  3. 10 råd for eff.klin.besl.støtte • Fart = alt, noen krav/forventninger: • Lav responstid fra it-system (raskt) • Tid for kommunikasjon med it-system < tilsvarende papirsystem • Prediker legens ønsker og lever de • Sanntid • Kontekst • Data Mining  adverse events

  4. 10 råd for eff.klin.besl.støtte • Pass inn i legens arbeidsflyt/vaner • Små endringer  stor forskjell • F.eks. Ikke lag lett ignorerbare viktige advarsler • Forstå at legen ikke kan stoppes • Stoppe legen ”i fart” funker ikke • Endre retning er bedre enn stopping • ”Systemkonstruktivitet”

  5. 10 råd for eff.klin.besl.støtte • K.I.S.S • Høflig system, spør når det må • Mål effekt, få feedback fra og svar legen • Drift og Vedlikehold kunnskapssyst. • Basert på 9.

  6. Avslutning • 10 nivåer for grad av ”itfisering” • US helsevesen stort sett på nivå 1 • Guidelines har fungert dårlig i primærhelse for kroniske sykdommer

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