Using Nursing Clinical Decision Support Systems to Achieve Meaningful Use

Abstract

The Health Information Technology and Clinical Health Act (one component of the American Recovery and Reinvestment Act) is responsible for providing incentive payments to hospitals and eligible providers in an effort to support the adoption of electronic health records. Future penalties are planned for electronic health record noncompliance. In order to receive incentives and avoid penalties, hospitals and eligible providers must demonstrate "meaningful use" of their electronic health records. One of the meaningful-use objectives established by the Centers for Medicare & Medicaid Services involves the use of a clinical decision support rule that addresses a hospital-defined, high-priority condition. This article describes the Plan-Do-Study-Act process for creating and implementing a nursing clinical decision support system designed to improve guideline adherence for hypoglycemia management. This project identifies hypoglycemia management as the high-priority area. However, other facilities with different high-priority conditions may find the process presented in this article useful for implementing additional clinical decision support rules geared toward improving outcomes and meeting federal mandates.

A Clinical Decision Support System Design Framework for Nursing Practice

“…59 Reasoning systems delivering prepackaged, patient-specific, and conflict-free decision support based on multiple evidence have shown promise to address the barriers and enhance clinical evidence adherence and improve patient outcomes. 9,46,60,61 For instance, a CDSS with a reasoning system should have the capability to synthesize CHF and diabetes nursing care guide to suggest prioritized and duplicate-free nursing interventions for supporting nurses' care planning.…”

The Relationship Between Magnet Designation, Electronic Health Record Adoption, and Medicare Meaningful Use Payments

“…[18] that describe how the application of the Magnet Model can be directly translated into successful EHR adoption practices in hospital settings. Although scholars have begun to investigate associations between nursing excellence and EHR use, [19–22] this research is important to nursing practice because it is the first study that examined Magnet hospitals’ outcomes compared to non-Magnet hospitals with the multiple measures of EHR adoption, the CMS’ Medicare EHR Incentive Program and the HIMSS Analytics EMRAM. Currently there are minimal data about the characteristics of hospitals that have received EHR incentive payments, [23] and this analysis offers evidence that nursing excellence, as operationalized by Magnet recognition, is a hospital characteristic that is positively associated with MU attestation.…”

Nursing decision support system: application in electronic health records†

“…2 To elaborate, NDSS is developed within the framework of EHRs, where the patient information is matched to the content of the computer knowledge base, aiming to calculate a feasible individualized nursing care plan for patients and optimize the nursing decision. 2,3 Most importantly, NDSS has a human-machine interaction mechanism to complete the patient data input and then generate decision support results to users. 4 Furthermore, NDSS features an extensive assortment of functions that can contribute to the decision-making in EHRs such as patient data reports, reminders and alerts, clinical guidelines, diagnostic support, and tools for clinical workflow.…”