When will we be able to hit the support button?

Clinical decision support (CDS) refers broadly to providing clinicians or patients with computer-generated clinical knowledge and patient-related information, intelligently filtered or presented at appropriate times, to enhance patient care. The goal is to improve quality, eliminate waste and lower costs.

There remain, however, significant barriers to the development, deployment, dissemination and implementation of CDS systems and platforms.

For CDS digipreneurs, there are other roadblocks:

  1. Integration into legacy EMR systems
  2. Liability issues
  3. Regulatory issues. Three documents from the FDA remove some doubts by describing various types of medical software and what sorts of claims would be regulated, but things are still fuzzy.
  4. Cultural issues
  5. Physician barriers to adoption and penetration
  6. Cost and reimbursement for use of CDS systems
  7. Security and confidentiality in the era of precision medicine using unique, large data sets
  8. Measuring ROI to garner investment
  9. Lack of sick care data scientists who are dedicated to the care and feeding of the systems
  10. Poor or non-existent education and training of medical professionals in how to use CDSs and the possible ethical pitfalls of doing so.

Clinical decision support systems span the gamut from symptom checkers, to point of care repositories to robust EMR embedded software. As with most medical technologies, the human use, economic and social barriers will be the biggest obstacles and will probable take a generation or two to overcome.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs