Clinical decision support tools, generally defined as technologies that provide information to aid the diagnosis and treatment of patients, are set to fundamentally change the way medicine is practiced.

This according to a recent report from British market analyst Datamonitor, which expects clinical intelligence solutions to be the next major trend in clinical decision support tools, followed by patient-centric and diagnosis-related CDS.

“As more healthcare organizations realize the value of and need for electronic health records, early adopters are already moving to add more advanced functionalities to their EHRs,” said Christine Chang, a healthcare technology analyst with Datamonitor and author of the study. “Without CDS, EHRs are not much more than a compilation of paper records in an electronic format.”

The conclusions in the report - Clinical Decision Support in Healthcare: One Step Closer to the Omniscient Clinician - have major implications for the way physicians will use CDS tools in healthcare IT applications, as the report points out that medical culture will be the premier obstacle to overcome in CDS adoption.

According to Chang, the idea that a computer could be more accurate than a physician is difficult for providers to accept despite numerous studies which have shown that algorithms and computers do outperform most doctors on some tasks.

“The ‘art of medicine’ is still highly regarded among providers, and critics of CDS maintain a computer cannot understand the nuances of medicine even when the technologies have been shown to improve efficiencies and outcomes,” said Chang. “It will take time as well as an increase in provider education and pressure from patients, payers and C-level hospital executives.”

CDS technologies range from online reference materials to guidelines, to alerts built into electronic prescribing and computerized physician order entry, to data mining and artificial intelligence. Most CDS tools today are targeted to providers and payers, but Chang said governments and even patients would also use CDS to a greater extent in the future.

William Bria, MD, chief medical information officer at Shriners Hospitals for Children, recently told an audience at the 2008 Physician-Computer Connection Symposium in Ojai, Calif., that medicine was “at the threshold of a new era in clinical decision support.”

Bria said CDS tools in healthcare IT applications could improve patient care, but only if physicians were proactive in translating care guidelines into CDS technology.

“We need to understand which guidelines are actionable and do a good job of translating them for use in CDS,” he said. “If the translation is not done well, we won’t have accomplished much at all.”