Decision support software can reduce hospitalisation

A study published in this month’s American Journal of Managed Care has found that clinical decision support software, backed up with electronic health records, can help to reduce hospital admissions and costs.

Hospital admissions of patients whose GPs were using decision support software were down by 19%, and costs were reduced by 13%. Nearly 35,000 patients from one care plan provider completed the 12-month study.

Half the patients in the study triggered recommendations from the software which could be viewed by their GP; the recommendations for the other half were recorded but not viewed.

Of the doctors who received recommendations from the software, 24% complied with the ‘add a drug’ suggestions. The study authors were unable to quantify how many GPs followed software advice to discontinue drugs as the data was unavailable.

The figure of 24% "leaves significant room for improvement", said the authors, who recommended that decision support software should do more to engage GPs, although the software used also contained caveats that their recommendations are often only based on limited information.

The authors of the study commented: "In an ideal world, clinical decision support systems would be embedded within comprehensive electronic health information environments that include medical records and order entry. The best moment to intervene and prompt a caregiver to comply with evidence-based guidelines is at the point of care, using detailed clinical information.

"Physicians are likely to be more responsive to prompts generated at the point of care, provided that those prompts are clinically on target and patient-specific. Unfortunately, few Americans (except for active-duty military and veterans) are cared for in an electronic healthcare environment that enables point-of-care systems."

In a statement issued by Active Health Management, manufacturers of the CareChoice system featured in the study, Jonathan Javitt, MD, scientific advisor to the software company, said: "Once electronic health records become more widespread, systems such as this will sit on top of those records and generate evidence-based recommendations in real time. Physicians need to be able to review patient data in the context of the latest, evidence-based standards of care."

The full text of the study is available on the American Journal of Managed Care website.