Clinical Decision-Support Systems Can Help Improve Provider Practices

Cardiovascular disease causes one out of every three (approximately 800,000) deaths each year in the U.S. (Go et al., 2013). It is the leading cause of death for both men and women (Murphy et al., 2013). About half of U.S. adults (49%) have at least one of the three key cardiovascular disease risk factors: high blood pressure, high cholesterol, and smoking (CDC, 2011). A recommendation from the Community Preventive Services Task Force (Task Force) can be used by healthcare organizations and providers to help facilitate the delivery of evidence-based care that has been proven to reduce patients’ risk for cardiovascular disease. The Task Force released the following recommendation:

The Community Preventive Services Task Force recommends clinical decision-support systems for prevention of cardiovascular disease (CVD) based on sufficient evidence of effectiveness in improving screening for CVD risk factors and practices for CVD-related preventive care services, clinical tests, and treatments.

The Task Force based its recommendation on a systematic review of all available studies focused on clinical decision-support systems for cardiovascular disease prevention. With oversight from the Task Force, scientists and subject matter experts from the Centers for Disease Control and Prevention (CDC) conduct systematic reviews of the scientific literature in collaboration with a wide range of government, academic, policy, and practice-based partners.

Based on a companion review of economic evidence that found limited evidence on cost and economic benefit, the Task Force was unable to reach an overall conclusion about the economic effectiveness of using clinical decision-support systems for cardiovascular disease prevention.

Using Clinical Decision-Support Systems for Cardiovascular Disease Prevention

Clinical decision-support systems are computer-based information systems designed to assist healthcare providers in implementing clinical guidelines at the point of care. These systems provide tailored patient assessments and evidence-based treatment recommendations for healthcare providers to consider using patient information that is entered either manually or automatically through an electronic health record system. A clinical decision-support system designed to assist providers in cardiovascular disease prevention gives one or more of the following:

• Reminders for overdue cardiovascular disease preventive services, including screening for CVD risk factors
• Assessments of patients’ risk for developing cardiovascular disease
• Recommendations for evidence-based treatments to prevent cardiovascular disease
• Recommendations for health behavior changes to discuss with patients
• Alerts when indicators for cardiovascular disease risk factors are not at goal

Commonly implemented in outpatient, primary care settings, clinical decision-support systems are often incorporated within electronic health record systems and integrated with other computer-based functions that offer patient-care summary reports, feedback on quality indicators, and benchmarking.

The systematic review is pending publication; however, a summary of the findings and supporting materials are available on The Community Guide website.

The Task Force and The Community Guide

The Community Preventive Services Task Force (Task Force) is an independent, nonfederal, unpaid panel of public health and prevention experts that provides evidence-based findings and recommendations about community preventive programs, services, and policies to improve health. Its members represent a broad range of research, practice, and policy expertise in community preventive services, public health, health promotion, and disease prevention.

The Community Guide is an essential resource for people who want to know what works in public health. It provides evidence-based findings about public health interventions and policies to improve health and promote safety. The reviews and the Task Force findings and recommendations are compiled in The Community Guide.

For More Information

• Community Preventive Services Task Force findings and recommendations to prevent and control cardiovascular disease
• CDC, Heart Disease
• Million Hearts campaign to prevent 1 million heart attacks and strokes over five years
• More than 225 Task Force findings and recommendations on 21 topics: www.thecommunityguide.org

References

Centers for Disease Control and Prevention. Million Hearts: strategies to reduce the prevalence of leading cardiovascular disease risk factors. United States, 2011. MMWR. 2011;60(36):1248 51.

Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics 2013 update: a report from the American Heart Association. Circulation. 2013;127:e6 245.

Murphy SL, Xu JQ, Kochanek KD. Deaths: final data for 2010. National Vital Statistics Reports. 2013;61(4).