Clinical decision support (CDS) has the potential to improve health care by reducing adverse events, enhancing clinical outcomes, increasing efficiency, and lowering costs. Unfortunately, due to poorly designed alerts and order sets, most health systems struggle to realize the benefits of CDS, and many find it actually hinders care delivery.

This research report provides two imperatives with six underlying strategies to help physician executives drive CDS performance improvement.

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Although high-performing CDS is critical to succeed on key strategic priorities such as care variation reduction and quality improvement, physician executives rarely give CDS the attention it deserves. To ensure CDS supports their strategic initiatives, physician executives must play a greater role in improving CDS performance by driving the organization to act on two imperatives: reduce “alert noise” and build higher-value CDS.

Six strategies to drive CDS performance improvement

Imperative 1: Reduce Alert Noise (p. 17)
Health systems should remove the multitude of poorly designed, low-value alerts currently in the EHR to reduce alert noise. Removing low-value alerts will reduce alert fatigue and habitual override, and begin to restore physicians’ trust in CDS.

• Strategy 1: Categorically Purge Low-Value Alerts (p. 20)
• Strategy 2: Prioritize Specificity Over Sensitivity (p. 29)
• Strategy 3: Use Physician Input to Identify Needless Alerts (p. 37)

Imperative 2: Build Higher-Value CDS (p. 45)
Health systems must redesign build processes to ensure that all new CDS is of higher value. High-value CDS guides care delivery by communicating the right information, to the right provider, at the right time, and through the right channel.

• Strategy 4: Focus CDS Requests on Problems, Not Solutions (p. 48)
• Strategy 5: Apply Standard, Objective Criteria to Prioritize CDS Requests (p. 51)
• Strategy 6: Proactively Discuss Clinical Goals with Informatics Leaders (p. 56)