This document is primarily intended for clinicians, staff, patients and other individuals to provide intelligently-filtered knowledge and personal-specific information in order to improve overall health and healthcare. The patient can, therefore, access information about his or her health and take action. For example, we have witnessed the case of a patient requiring a mammogram; it can be accessed online, even including a doctor’s appointment, and in this way enhance health care. Clinicians can use this information to access the latest treatments in order to make prescriptions, get patients’ test results and even be consulted by patients on different issues.
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Hospital staff, such as nurses, are also able to access patient information, consult with patients and even give advice where needed, all these with confirmation from the doctor. All this information can be used for mass education on certain diseases, their symptoms, cure and prevention through dissemination of information. Sometimes, this information can be used when making financial decisions, such as purchasing health insurance. This is useful to the patient because they know their current medical status before purchasing any insurance or making other financial decisions.
Organizations that are involved include Roadmap Execution Steering Group (RESG), which helps in initiating tasks for clinical decision support to establish formal mechanisms for gathering input from the many clinical decision support stakeholders. They include Bridges to Excellence Organization, Doctors Office Quality-Information Technology Program, Healthcare Information and Management Systems Society (HIMSS), American Academy of Family Physicians (AAFP), National Quality Forum (NQF) that pays for performance initiatives, National Library of Medicine(NLM) and American College of Physicians.
Other organizations include;
- Clinical information system and clinical decision support suppliers whose main contribution is to help provide content and infrastructure that would aid in delivering the roadmap.
- American Health Information Community (AHIC) which helps in leveraging momentum and energy to aid in accomplishment of clinical decision projects.
- AHRQ that is aimed at advancing health care information technology and clinical decision support, including funding key elements of the project.
- Certification Commission on Healthcare Information Technology (CCHIT) which is a high focal point of professionals who can play part in the program
- The Institute of Medicine (IOM) which brings together potential stakeholders from key areas.
Evidently, there is no government funding involved as the document only talks of proposed policies, which are supposed to help in encouraging individuals and organizations to start using clinical decision support. There is also the mentioning of recognition of the works of the various contributors and the roles they played in accepting any government contribution. Funding is from a federal agency and stakeholder agencies like NQF. More funding comes from non-governmental organizations, such as NHQRF.
A reporting mechanism is yet to be established, but from the available roadmap report it can be seen that there are several organizations in both the private and public sectors. They are engaged in clinical decision support and no system of communication has yet been developed. There is no coordination of any form of information between these organizations and thus the formation of RESG which undertook activities on the critical path of this roadmap.
The formation of RESG was through funding from a federal agency or a number of stakeholder agencies, such as AHRQ. The RESG would help in;
- bringing together various stakeholders
- Identify existing healthcare information and health care delivery for the purpose of fulfillment of the tasks in the critical path.
- There will be demonstration of project requirements where clinical decision support systems will be used in existing projects.
- A forum will also be created which will aid in building a shared clinical decision support vision, and in turn accelerate a clinical decision support progress in health care access.
There is a proposed tentative timeline for the clinical decision support project which is to run from June 2006 to June 2009. In my opinion, it is possible to summarize all these activities in a few pages after the roadmap is complete as it is very clear that there are not too many activities to be done during the roadmap writing. It is likely that most activities could take longer than originally estimated, especially considering the fact that we are dealing with an array of organizations and stakeholders. Even though, this has been experimented on before without any success, this is an improved version basing on the previous experiments, and thus it can be concluded that it is possible to succeed in this endeavor.
Once we have the funds and the ultimate promise from the various stakeholders not to fail us, then the creation of forums can proceed unhindered. It is true to say that something has happened since this roadmap. Even though, there is no evidence of success in key areas, such as funding or successful collaboration with all stakeholders, some have already started working on the project. We are told that most of the stakeholders who have already been contacted have to wait for extra funding, and are currently working within the specifications of the funds available. The epitome of all these is that there is still a question of whether this project will overcome its challenges, once adopted as a worldwide measure of improving health and healthcare systems. We also hope that the project will yield more benefits than detrimental effects to all concerned parties.
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