FDB (formerly First Databank) is well-known for providing drug knowledge and clinical decision support that help healthcare professionals make precise decisions.

In Booth 1747 at HIMSS24 taking place in Orlando this week, the company is talking with attendees about the need for patient-specific clinical decision support, timing medication decision support alerts and additional guidance for healthcare providers only when pertinent to a patient's immediate care needs, proactive maintenance of CDS and physician burnout.

We interviewed Anna Dover, PharmD, director of product management at FDB, for a look into these issues.

Q. At HIMSS24 you've been talking "patient-specific" clinical decision support. Why the stress on patient-specific? Please elaborate.

A. Physicians, nurses and pharmacists are inundated with clinical decision support alerts throughout their day. While the notifications are intended to protect patient safety and health, many of them can be non-specific, offering guidance that is not relevant to that particular clinical scenario or patient.

For example, a physician may prescribe a drug that can increase potassium in the blood – a condition called hyperkalemia – yet that same patient is also taking a drug that depletes potassium. An alert to warn of the concern for hyperkalemia is not necessarily relevant for this patient. To really determine if there is a safety concern, the patient's labs must be considered.

Bringing this additional context, this patient specificity, to the alert reduces noise and provides more meaningful and impactful alerts. Alert fatigue is well-documented as it can lead to clinicians overlooking or dismissing alerts that require their attention and action.

Making CDS specific to the patient and situation at hand can reduce alert fatigue, but more importantly, better protect patient safety and health. Medication alerts can help prevent errors and optimize drug therapy decisions when they are meaningful and relevant to the clinician and the patient in focus.

Q. You've been talking about timing medication decision support alerts and additional guidance for healthcare providers only when pertinent to a patient's immediate care needs. This clearly seems aimed at fighting physician burnout. How is this effort coming along?

A. There is certainly greater awareness of burnout today than before the pandemic. Clinician burnout was brought into stark focus in the last several years as physicians, nurses and virtually everyone involved in healthcare became overwhelmed and exhausted caring for so many with limited staff and resources.

Health systems today continue to face dire staffing shortages across nearly all clinical roles due to the high rate of resignations and turnover. As a result, many more organizations are prioritizing improvements to reduce and prevent burnout.

Leading health systems have been looking at ways to streamline workflows, automate steps and deliver the right information at the right place in the workflow so the clinician does not have to dig through records or search clinical guidelines to make a fully informed decision.

The health systems we work with have taken major steps forward in improving the relevancy of medication alerts while reducing the overall volume. By leveraging the right CDS technology, they can make rapid progress without impacting other high-priority projects or increasing their maintenance burden.

Q. What have providers been telling you is the biggest decision support challenge they face other than alert fatigue that leads to burnout? And how do you suggest overcoming it?

A. The biggest challenge is proactive maintenance of CDS. In healthcare, change is constant, with medical evidence and guidelines constantly evolving. It can be challenging to keep up with the rate of change when there are so many other priorities for health system EHR teams. Lack of proper maintenance can lead to CDS malfunctions, leading to missing alerts or even inaccurate alerts.

Finding ways to reduce the maintenance burden is critical. Many health systems we work with have adopted our patient-specific medication content because we handle the maintenance for them.

We have experts who continually review the latest studies from thousands of journals, guidance from medical societies and integrate that into our solutions. We communicate updates so they can determine what impact it may have on them.

Follow Bill's HIT coverage on LinkedIn: Bill Siwicki
Email him: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.