Providers are increasingly clamoring for clinical decision support (CDS) tools, but simple plug-and-play products don’t exist yet, and CDS tools developed locally often have similar problems, according to a report from KLAS. 

“Order sets, care plans and drug databases have the potential to be among the most impactful forms of CDS,” according to the Orem, Utah-based market researcher's report. “Ideally, they are deeply embedded in the EHR and have the opportunity to influence point-of-care decisions made by a wide range of healthcare professionals. However, these CDS tools are only just beginning to scratch the surface of their potential.”

A 2011 KLAS report revealed that providers believed EHR-embedded CDS helped to standardize care, but that alert fatigue was a major challenge. According to a KLAS survey of nearly 300 providers published in January, those problems remain two years later.

Order sets have the potential to streamline computerized order entry systems and ensure to a higher degree patient safety, but whether developed in-house or by a third-party vendor, they are not gaining much traction in clinical settings. More than one-half of providers using third-party products responded that they use order sets as reference only and not as a tool. Going live with order sets, getting physicians to adopt the tool and maintain order sets all present problems, according to the report.

While many survey respondents expressed an interest in care plans and many organizations responded that they have attempted to develop their own, integrating some third-party tools into EHRs proved to be a problem and many respondents complained that care plans were not specific enough or relevant enough.

Nearly all respondents maintained drug databases and nearly all turned on alerts for drug allergies and drug-drug interactions, but there were still qualms. Many believed that drug database alerts should be more meaningful, that alerts should be more customizable and that, when customizable, it took too much work.

“Maximizing the effectiveness of these solutions is no easy task,” the report read. “There are few best practices, and the path taken to effective use is varied and often specific to healthcare organizations.”