Now days Physicians are increasingly willing to consider information technology (IT) to support clinical practice. Especially those tool that will suitable for their work and at least time and revenue neutral. So to accomplish such goals is to build decision supports system. The system that will improve patient care. It deals with Hospital Information System to automate diagnosis, and produce reminders and guidelines that help Physicians, Nurses and Patient in managing the patient care.
According to Wyatt J, Spiegel halter D Clinical Decision Support Systems is "active knowledge systems which use two or more items of patient data to generate case-specific advice. The core function that CDSS support may include supporting clinical coding, keeping patient on research process and according to this research referring treatment plan by automating protocol.
As CDSS is Knowledge base system that provide clinical information ,drug ratio for specific patient for his specific daises .Now the question who it work .actually CDSS has a smart program that is interconnected with patient history .Then there is a date bus that carry these information to CDSS engine. The engine convey relevant information that is output of engine (e.g., lists of possible diagnoses, drug interaction alerts or preventive care reminders).
CDSS can be built into the EMR ( Electronic Medical Records )or hosted as a standalone application available on the network, or on a mobile device, like a smart phone-based dosage calculator. Its knowledge base may be available centrally for local use as needed, or locally with constant upgrades. Practically, a deployed CDSS could utilize any of these computational architectures, methods of access or devices. The way these elements are constructed and deployed will depend on the type of clinical automation systems in place, local vendor solution availability, clinical workflow, security issues and funding constraints.
But CDSS has some limitation and can not be use within large enterprise. the most obvious barrier is lack of standerd.One recent example of an unsuccessful CDSS to improve the care of patients with asthma or angina found three main problem areas:
1. Timing of the guideline trigger.
2. Ease of use of the system.
3. Helpfulness of the proffered content.
Due to these barrier Kyung Hee University, Korea has initiated a project with Smart CDSS.It is novel approach that support Clinical system by using adapters that translate date format into standers CDSS input .it use sensor technology that is deployed in cloud infrastructure, and provide ultimate application to social media for guidelines and reminder in clinical area.
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