Clinical Decision-making Models, Strategies, and Support Systems

00:00 Today, we're going to delve into the role of informatics in clinical decision-making.

00:05 Now, we're going to explore various models, strategies and support systems.

00:09 So let's get going.

00:11 Clinical decision-making is a complex process.

00:14 Now, it requires synthesizing patient data, medical knowledge and individual preferences in order to determine the best course of action.

00:23 Now, informatics has many valuable models, and this is what we use to guide healthcare professionals through this really intricate process. Now, one of the most widely used models is the evidence-based practice model, and you've probably heard of that before.

00:41 Now, it combines the best available research evidence with clinical expertise and patient values and this is what promotes the informed decision-making process.

00:52 The EPI model involves asking focused questions, acquiring relevant evidence and appraising the quality and applicability of that evidence.

01:01 Then we apply it to patient care and assess the outcomes.

01:04 Now, by leveraging informatics, healthcare professionals can access a huge array of electronic databases.

01:12 They can also go for medical journals and clinical decision support systems that support the EPI process.

01:19 Informatics also provides strategies for clinicians to make decisions.

01:24 Now, these strategies are built into what are called clinical decision support systems or CDSS.

01:32 These computer-based tools provide clinicians with real-time, evidence-based recommendations, alerts and reminders right at the point of care.

01:42 Have you ever wondered how your local pharmacy knows what stickers to put on your medication bottles and what instructions to print with your medications? Well, this information is all organized in a CDSS system.

01:56 Now, it not only figures out what you need to know for the single prescription, but what you might need to know specifically for all the other medications or diseases unique to you. Another strategy to make clinical decisions that is powered by informatics is the use of data analytics.

02:14 Now, by harnessing the power of informatics, healthcare professionals can analyze large volumes of patient data.

02:21 They can also identify trends and uncover insights that inform their clinical decision-making.

02:27 This is the kind of data work that feeds directly into practice guidelines, for example, of which drug classes tend to work better for what symptoms or what should be first, second and third-line treatment choices based on large patient populations. Now, support for clinical decisions can also be embedded within other systems, such as the electronic health record.

02:48 Now, these support tools can be designed and used to alert, notify and recommend specific choices for specific patient values. Now, they can also be connected to standardized order sets to increase efficiency. For example, a patient's blood culture may be reported as positive for a particular strain of bacteria.

03:09 The provider can memorize all the possible antibiotic choices and consider the patient's specific variables such as age, comorbidities, other medications, organ health, cost, convenience and so on.

03:22 Or the clinical decision-making informatics tool can be used to alert the provider.

03:28 This tells the provider what specific evidence-based guidelines there are for the specific strain, incorporating the specific patient variables, and then links this information directly to the order set, including the right drug, the right dose, the right route, the right timing and so on for that patient, all within a few moments of the lab being reported.

03:50 Now, with over 20,000 different medications approved for prescribing and hundreds of diseases to know about, clinicians need support to ensure they're making the best choices they can.

04:02 Now, the integration of informatics into the clinical decision-making empowers healthcare professionals with access to extensive knowledge, real-time guidance, data-driven insights that are ultimately leading to improved patient outcomes and enhanced quality care.