The Association of Ontario Health Centres for example, had an Education and Capacity Building Team and four Regional Decision Support Specialist positions that worked on the majority of programs.
42 43 Offsetting this were enablers centred on greater dialogue with patients to increase understanding and facilitate shared decision-making, 29 30 31 44 46 as well as timely access to, and decision support from, specialists, particularly geriatricians and psychiatrists.
In addition to case management support, primary care providers receive consultation and decision support from mental health specialists (i.e., psychiatrists and psychologists).
The most common telestroke configuration is a "hub-and-spoke" model, whereby a central "hub" organisation provides remote audio-visual access to a stroke specialist for decision support in a number of peripheral hospitals.
Cardiac specialists could use decision support algorithms before electrophysiology referral to enable more informed, shared decisions about potential risk-benefit tradeoffs from ICD implantation.
She is a project specialist in the decision support and quality management unit at Massachusetts General Hospital in Boston.
Point of service reminders, educational prompts, and recommendations to consult specialists would all be useful decision support tools within an EMR to help providers maintain awareness of the changing pace of genetic technologies.
The investments in decision support (guideline dissimination, provider education, regional feedback, support by specialists) have certainly raised the awareness regarding the need for a more stringent therapeutic approach of diabetes (timely upgrading of diabetic medication and cardiovascular risk assessment).
1 It follows then that implementation specialists introducing new technology and computerised decision support (CDS) tend to use quality improvement methods popularised by Deming (ie, the Plan-Do-Study-Act (PDSA) cycle) and Donabedian (ie, Structure-Process-Outcome (SPO) framework).
However, if, as is likely, review by experienced critical care physicians is impractical, decision support will be required for the non-critical care specialist.
