Integration and more user input: South Korea anticipates the next wave of CDSS development
28 Feb 2024
Two key themes emerged when the evolving role of the clinical decision support system (CDSS) in South Korean hospitals was the focus of a CXO networking night hosted by HIMSS and Wolters Kluwer last year: the need for tighter integration with EMRs and hospital systems, and for CDSS development to be more reflective of clinical user experience and workflow.
These themes, as well as other influential trends (including the increasing use of AI in healthcare technology and the growing use of CDSS in clinical research), were assessed extensively by expert participants from South Korea and further afield. Their input has now been collected in an eBook which summarises their discussions, presents a snapshot of the country’s CDSS landscape, and considers the opportunities it offers to further reduce medication errors, enhance clinical user experience, and improve healthcare delivery.
According to Christian Cella, international market vice president for Clinical Effectiveness at Wolters Kluwer, medication errors continue to be the most serious adverse event in Korea’s hospitals. Despite the implementation of CDSS, false alarms cause alert fatigue and staff do not follow the system’s prescription recommendations.
Leading a discussion about the improvement of patient care with medication decision support, Cella said Wolters Kluwer’s clinical advisory team estimates that 15.7% of hospitalised patients suffer adverse drug events, and hospitalisation is prolonged by 3.1 days for those affected. If a system such as Wolters Kluwer’s CDSS is fine-tuned to different clinical phases, it can improve both patient safety and healthcare processes.
"Although medication errors are serious, they can be sufficiently prevented through CDSS," he said. "In addition, by introducing a CDSS set that can be integrated and utilised together and work efficiently, safety management can be maximised. This plays a big role in improving patient safety, the most important value pursued by hospitals beyond simple information delivery."
In addition to the framing of medication safety, the event focused on technology considerations and preventative strategies and direction.
Much of the conversation emphasised the need for greater integration with drug information management and other hospital systems, helping to better meet clinical user expectations and align more closely with workflows.
"Just as we no longer want to memorise phone numbers, we expect the system to manage prescription-related references and contribute directly to prescriptions," said Professor Wonchul Cha, CMIO, Director, Digital Innovation Center, Samsung Medical Center. "Hospitals need to integrate and manage those enhanced CDSS."
The subject of enabling technology was also explored by Prof Ho-Young Lee, director of Research and Development and former CIO at Seoul National University Bundang Hospital, which provided a valuable case study of CDSS implementation during the event. Prof Lee said that while AI’s role in CDSS development will ultimately benefit patient safety and the work of hospital staff, most current AI systems in healthcare are designed without reflecting user experience.
While patients and staff in South Korean hospitals are already benefiting from advances in CDSS, Prof Lee said that more work needs to be done to create value from these systems.
"Any CDSS is just a tool, and how people can use the tool well to create value is something we need to think about more," he said. "It is our job to bring it to fruition. Creating better value for patients and providing help is the reason hospitals exist and the reason we see patients. I think we should use IT with a little more focus on that."
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