Among CVRM patients , the results tended towards a beneficial effect of CDSS , but only LDL-c target attainment in diabetes patients reached statistical significance .
Prompting , integration into the electronical health record , patient empowerment , and medication support were related to more effective CVRM .
Conclusion We did not find a clear clinical benefit from CDSS in cardiovascular risk factor levels and target attainment .
Some features of CDSS seem more promising than others .
Clinical relevance of CDSS in CVRM might additionally be sought in the improvement of shared decision making and patient empowerment
Background Cardiovascular risk management ( CVRM ) is notoriously difficult because of multi-morbidity and the different phenotypes and severities of cardiovascular disease .
Computerized decision support systems ( CDSS ) enable the clinician to integrate the latest scientific evidence and patient information into tailored strategies .
The effect on cardiovascular risk factor management is yet to be confirmed .
The effect of the Vermont Diabetes Information System on inpatient and emergency room use: results from a randomized trial.
OBJECTIVE : To describe the effect of the Vermont Diabetes Information System ( VDIS ) on hospital and emergency room use DATA SOURCE : Statewide discharge data base STUDY DESIGN : R and omized controlled trial of a decision support system for 7,412 adults with diabetes and their 64 primary care providers . DATA COLLECTION / DATA EXTRACTION : Charges and date s for hospital admissions and emergency room care in Vermont during an average of 32 months of observation . Data from New York hospitals were not available . PRINCIPAL FINDINGS : Patients r and omized to VDIS were admitted to the hospital less often than control subjects ( 0.17 admissions vs. 0.20 ; P=0.01 ) and generated lower hospital charges ( $ 3,113 vs. $ 3,480 ; P=0.019 ) . VDIS patients also had lower emergency room utilization ( 0.27 visits vs. 0.36 ; P<0.0001 ) and charges ( $ 304 vs. $ 414 ; P<0.0001 ) . The intervention was particularly effective in men and in older subjects . CONCLUSIONS : In spite of data limitations that tended to reduce the apparent effect of the system ; this r and omized , controlled trial showed that VDIS reduces hospitalization and emergency room utilization and expenses
Among CVRM patients , the results tended towards a beneficial effect of CDSS , but only LDL-c target attainment in diabetes patients reached statistical significance .
Prompting , integration into the electronical health record , patient empowerment , and medication support were related to more effective CVRM .
Conclusion We did not find a clear clinical benefit from CDSS in cardiovascular risk factor levels and target attainment .
Some features of CDSS seem more promising than others .
Clinical relevance of CDSS in CVRM might additionally be sought in the improvement of shared decision making and patient empowerment
Background Cardiovascular risk management ( CVRM ) is notoriously difficult because of multi-morbidity and the different phenotypes and severities of cardiovascular disease .
Computerized decision support systems ( CDSS ) enable the clinician to integrate the latest scientific evidence and patient information into tailored strategies .
The effect on cardiovascular risk factor management is yet to be confirmed .