Foreword The purpose of clinical decision support is “to translate knowledge into evidence-based practice in clinical settings.” 1 Clinical decision support can improve healthcare in a range of ways. It can reduce medical errors; it can ensure that healthcare professionals follow guidelines; and it can also save costs. 2
within BMJ Best Practice can be put into practice to drive quality improvement. The BMJ Best Practice Comorbidities Manager outlines how to better care for the growing number of people with multiple illnesses. Our physical and mental healthcare content gives clear guidance on how to achieve holistic care. The content on cancer helps healthcare professionals avoid the twin perils of over and underdiagnosis. The topics on cardiology and infectious disease cover diagnosis, management, and follow-up, and of course prevention. Our new content on frailty gives guidance on how to come to shared decisions with patients and their families and how to proactively manage this condition. Lastly, the technology underpinning BMJ Best Practice should enable it to be available to healthcare professionals where and when they need it - on a mobile, on an app, and increasingly integrated into the electronic healthcare record. These are current areas of emphasis for BMJ Best Practice. But we are interested in your views also. We have built BMJ Best Practice with our users – and we plan to continue to develop it with people like you. If there are other areas that you feel we should focus on, we would be delighted to hear from you. BMJ Best Practice is freely available in the NHS in England, Scotland, and Wales. Please get in touch if you would like to find out how to make it available in your organisation.
There is a growing research base as to what works in clinical decision support. Such support must provide knowledge that is evidence-based, continually updated and at the same time practical and actionable. Clinical decision support must be fast; it must fit with the clinical workflow; and it must deliver in real-time. 3 It must be available online and offline (via an app) and must work on whatever electronic device that the healthcare professional uses. Ideally, clinical decision support must be usable at the point of care and must be integrated with other relevant resources - from drug formularies to medical calculators. This is a brief summary of where clinical decision support is today. But another important point is that clinical decision support should not stand alone. It should be based on the needs of patients and populations, and the needs of healthcare professionals who serve those patients and populations. The Independent Investigation of the National Health Service in England by Lord Darzi gives a comprehensive outline of the needs of the health service in England. 4 The Darzi review touches on a wide range of topics - but certain issues stand out such as multimorbidity, mental health, and cancer care. This short briefing paper shows how BMJ Best Practice can help with these problems. It gives straightforward examples of how the knowledge
Dr Kieran Walsh. Clinical Director, BMJ Group
Sources: 1. Khong PC, Holroyd E, Wang W. A Critical Review of the Theoretical Frameworks and the Conceptual Factors in the Adoption of Clinical Decision Support Systems. Comput Inform Nurs. 2015 Dec;33(12):555-70. 2. Castillo RS, Kelemen A. Considerations for a successful clinical decision support system. Comput Inform Nurs. 2013 Jul;31(7):319-26. 3. Bates DW, Kuperman GJ, Wang S, Gandhi T, Kittler A, Volk L, Spurr C, Khorasani R, Tanasijevic M, Middleton B. Ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality. J Am Med Inform Assoc. 2003 Nov-Dec;10(6):523-30. 4. Independent Investigation of the National Health Service in England. Lord Darzi. September 2024 Competing interests, KW works for BMJ.
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