Data + Analysis = Decision Support. Rema Padman, PhD Professor of Management Science and Health Informatics The Heinz School Carnegie Mellon University MMM Program [email protected] Outline - Day 1. Introduction Motivation Illustrative Examples DSS Analysis Framework
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Volume of Information
Provider InformationProcessing Capacity
Preventive care systems
Other medical care
All CDSS studies
Evidence for CDSS Adoption?DL Hunt, RB Haynes, SE Hanna, K Smith. Effects of computer-based clinical decision support systems on physician performance and patient outcomes. JAMA 1998 280: 1339-1346.
“It is simply unrealistic to think that individuals can synthesize in their heads scores of pieces of evidence, accurately estimate the outcomes of different options, and accurately judge the desirability of those outcomes for patients.”
David M. Eddy, MD, PhD
JAMA 1990, 263:1265 - 1275
Building efficiency, effectiveness, and quality into healthcare delivery and administration
Payers will focus on these co-dependent variables to reduce costs and improve care
The two are inextricably related…essential to manage how care is delivered to manage costs and improve care
Care is based primarily on visits.
Care is based on continuous healing relationships.
Professional autonomy drives variability.
Care is customized according to patient needs and values.
Professionals control care.
The patient is the source of control.
Information is a record.
Knowledge is shared and information flows freely.
Decision making is based on training and experience.
Decision making is evidence-based.
Do no harm is an individual responsibility.
Safety is a system property.
Secrecy is necessary.
Transparency is necessary.
The system reacts to needs.
Needs are anticipated.
Cost reduction is sought.
Waste is continuously decreased.
Preference is given to professional roles over the system.
Cooperation among clinicians is a priority.
Transforming Health Care with IT
SOURCE: Table 3-1 in Crossing the Quality Chasm, IOM, 2001
Using Patient Care Management to Preserve and Enhance Profitability Gartner Inc., September, 2002
PriceWaterhouse Survey of 400
Healthcare Thought Leaders
Short-term impactOrganizational Context
or unstructured decisions
past and present
software for data
Guidelines and Pathways