Technological Underpinnings
Common features of CDS systems that are designed to provide patient-specific guidance
include the knowledge base (e.g., compiled clinical information on diagnoses, drug interactions,
and guidelines), a program for combining that knowledge with patient-specific information, and
a communication mechanism—in other words, a way of entering patientdata (or importing it
from the EMR) into the CDS application and providing relevant information (e.g., lists of
possible diagnoses, drug interaction alerts, or preventive care reminders) back to the clinician.
CDS can be implemented using a variety of platforms (e.g., Internet-based, local personal
computer, networked EMR, or a handheld device). Also, a variety of computing approaches can
be used. These approaches may depend on whether the CDS is built into the local EMR, whether
the knowledge is available from a central repository (possibly outside the local site and accessed
and incorporated locally when needed), or whether the entire system is housed outside the local
site and is accessed, but not incorporated into the local EMR. Inprinciple, any type of CDS
could utilize any of these underlying computational architectures, methods of access, or devices.
The choices among these elements might depend moreon the type of clinical systems already in
place, vendor offerings, workflow, security, and fiscal constraints than on the type or purpose of
the CDS.
Technological Underpinnings
Common features of CDS systems that are designed to provide patient-specific guidance
include the knowledge base (e.g., compiled clinical information on diagnoses, drug interactions,
and guidelines), a program for combining that knowledge with patient-specific information, and
a communication mechanism—in other words, a way of entering patientdata (or importing it
from the EMR) into the CDS application and providing relevant information (e.g., lists of
possible diagnoses, drug interaction alerts, or preventive care reminders) back to the clinician.
CDS can be implemented using a variety of platforms (e.g., Internet-based, local personal
computer, networked EMR, or a handheld device). Also, a variety of computing approaches can
be used. These approaches may depend on whether the CDS is built into the local EMR, whether
the knowledge is available from a central repository (possibly outside the local site and accessed
and incorporated locally when needed), or whether the entire system is housed outside the local
site and is accessed, but not incorporated into the local EMR. Inprinciple, any type of CDS
could utilize any of these underlying computational architectures, methods of access, or devices.
The choices among these elements might depend moreon the type of clinical systems already in
place, vendor offerings, workflow, security, and fiscal constraints than on the type or purpose of
the CDS.
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