Clinical Decision Support Systems (CDSS) represent a critical component of healthcare vital to improving patient care and outcomes in a variety of ways. The concept of clinical decision support (CDS) has been important for many years. CDS has expanded from its traditional content-centric role to become an information system that includes a variety of resources and services. While CDSS have advanced due to the increased use of innovative information technology, a functional model based on the five rights continues to apply to the role and effectiveness of CDSS.
The five rights include:
- “The right information: evidence-based, suitable to guide action, pertinent to the circumstance
- To the right person: considering all members of the care team, including clinicians, patients, and their caretakers
- In the right CDS intervention format: such as an alert, order set, or reference information to answer a clinical question
- Through the right channel: for example, a clinical information system (CIS) such as an electronic medical record (EMR), personal health record (PHR), or a more general channel such as the Internet or a mobile device
- At the right time in workflow: for example, at time of decision/action/need.”1
The five rights model defines the essence of successful CDSS. However, CDSS have evolved based on advances in Health Information Technology (HIT) along with regulatory pressure to achieve “Meaningful Use” of electronic systems. Frost & Sullivan defines the evolving CDSS landscape according to four major market segments:
- CDS Clinical Guidelines and Evidence-Based Medicine
- CDS Analytics
- CDSS Medical Workflow Solutions
- Point of Care (POC) Solutions
Frost & Sullivan believes that the Point of Care (POC) Solutions segment represents a significant growth opportunity moving forward, as the technology matures and adoption increases. The extension of CDSS to include digital tools that are available at the Point of Care represents a component of the market that will be a key component of growth in the CDSS space. POC solutions include several digital tools, one of the most prominent being the Electronic Medical Record (EMR). In many cases EMR suppliers are partnering with medical content providers to include access to these resources directly within the EMR or via links to this content. The EMR has become an integral part of CDSS. In addition, POC solutions include data derived from a variety of medical devices and patient monitors; such as in-hospital or remote patient monitoring systems. Emerging market segments within POC include clinical surveillance systems that involve advanced algorithms and data management systems that can be used to prevent serious conditions from occurring. Finally, there is also an emerging opportunity for cloud-based CDSS platforms that can be used to achieve interoperability across various systems that are currently limited to connectivity within their own organizations.
CDSS represent a vital component of the healthcare enterprise and have evolved from a paper-based content-driven solution to become connected digital workflow systems that offer all medical stakeholders access to critical decision making data, analytics, workflow process improvements and point of care solutions. CDSS are likely to increase their potential to improve patient outcomes. It is poised to generate the data needed, as healthcare reimbursement models evolve to value-based formulas and risk-based models become more prevalent. CDSS will also play a vital role in developing the data models needed to increase the prevalence of Population Health Management Systems.
Frost & Sullivan’s in-depth report on the CDSS market and growth potential will be published and available in May 2017. This report will explore the four major market segments included here and provide more details about opportunities and challenges faced by all stakeholders.
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 Institute for Healthcare Improvement. The Five Rights of Medication Administration (link is external); accessed 9/30/2008.