As the GMV model has begun to diffuse into practice, there is evidence that it improves processes of care but has little effect on metabolic outcomes.
Ultimately, the utility of a CDS protocol will be first judged by how often it is actually used when intended and, if used, whether the protocol improves processes of care and patient outcomes.
Based on that prior work, limitations from previous nonrandomized quality improvement studies and promising gains in process of care measures demonstrated from previous randomized trials, we and the Cardiological Society of India Kerala chapter sought to develop, implement, and evaluate a quality improvement intervention to improve process of care measures and clinical outcomes for these patients.
Checklists are clinical decision support tools that improve process of care and patient outcomes.
Benefits have been found in improving process of care but there is less consistent evidence for impact on health status [ 59, 62- 64].
Other recent results indicate that computerized clinical decision support systems (CCDSSs), a feature that is often linked to the EHR, inconsistently improved process of care measures and seldom improved patient outcomes.
Ideally this would be in a randomised controlled trial as though there is evidence that an electronic decision support system can improve process of care and some clinical markers of quality of diabetes care the published literature is limited [ 13].
Improving processes of care may not necessarily translate to improvement in patient outcomes; longer term prospective studies are needed to determine whether similar interventions reduce adverse outcomes such as progression of CKD and cardiovascular events.
Rather than directly rewarding improved patient outcomes, these schemes generally provide incentives to doctors for improving processes of care (for example, blood pressure checks for patients with hypertension) and intermediate outcomes (for example, cholesterol control in people with diabetes).
