Feeling indecisive? Try the decision support system.

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Every day, starting from waking up, we are faced with situations that require a decision to be taken for each step. Will we wake up straight or extend our sleep for just a few minutes? What will we wear for today? What will we have for breakfast, or lunch? What type of transportation will we take? At what time do we need to start walking in order to be on time for today’s schedule?

Sometimes, we make decisions on simple things, but not uncommonly we also decide on something more complex that have a more long-term impact. Have you ever been in a difficult situation where you find yourself become indecisive? Or you have made your decision but you still feel that you need a confirmation to support your decision?

Decision Support System

“Quick decisions are unsafe decisions,” so said Sophocles, but is it still relevant in the healthcare setting, where you are supposed to provide quick yet safe decisions? In the healthcare setting, whether admitted or not, actually the practitioner also needs a support system in the decision-making process related to patient care. Since the diagnostic phase until the phase to deliver a health (or sometimes, death) statement, could not be separated from the decision-making process, which is actually vulnerable to errors. This vulnerability was reported by Insitute of Medicine on 1999, named ”To Err is Human”, which was globally eye-opening to the acceptance of how unsafe the healthcare system can be, but also as an initial point for the rapid improvement of the integration of ICT into the healthcare, including for the purpose of decision support.

A series of methods supporting the decision making process related to healthcare, hence named clinical decision support (CDS) systems, started from a manually performed process, such as the use of a certain scoring system to aid in diagnosis establishment or deciding the treatment modality, now have developed into a more automated process performed by the CDS software.  Of course, the aim of CDS implementation within the practice is not to substitute the role of a healthcare practitioner, but as its name says, to provide support, to enhance a better decision making process thus one can expect to increase the safety, efficacy, and efficiency of the care delivery process.

KI students won all the prizes

Last week, my colleagues and I attended a CDS application developing competition. At this year’s event, all the finalists were the second year KI’s students from the Master’s in Health Informatics Programme, an All Karolinska’s Final!

The first place was achieved by a team formed by Mark Bothe, Tom Seinen, and Daniel Keszthelyi. They developed a CDS application to convert the doses of several opioid type drugs, which are the pain management medications, into the Morphine Milligrams Equivalent (MME) dose. Pain complaints could be very impairing to one’s quality of life, especially in the long term. Often, the management is far from simple and a multidisciplinary approach is necessary, thus might be involving the combination of several medications. This could lead to an increased risk of incorrect cumulative dose, which is measured in the term of MME. The MME is very useful in determining the overdose potential for certain patients, however, the conversion of each drug dose into MME requires complex mathematical calculation, thus here the role of a CDS application would be beneficial for the physician in the calculation and simplifying the daily dose adjustment so that the physician can ensure that the prescribed drug doses are still within the effective yet safe range.

The second place was obtained by Aulia Zahrina Qashri, who developed a CDS application for calculating the vitamin D prescribing dose. Vitamin D deficiency quite often was an underlooked problem, but still could impact to one’s overall health status. Not seldomly, a physician prescribed vitamin D based on the clinical judgement, but this usually resulting in the patient failing to reach the desired serum vitamin D level in the expected amount of time. To prescribe a more effective dose of vitamin D in order to achieve an adequate level of vitamin D thus alleviate the patient’s clinical condition, a physician can use a predictive equation to calculate the recommended daily replacement doses of vitamin D. However, the equation has complicated calculations involving data from the results of physical and lab exams. The calculation could cost time, the time that might be used for better doctor-patient engagement. Here the role of CDS application is prominent to facilitate the physician in getting quicker yet more effective suggested doses, also could help to save the healthcare budget by reducing ineffective medication prescriptions.

These finalists’ contributions are very valuable for the quality improvement of care and for the patient safety. They have definitely inspired other students at the Health Informatics programme, including me, on how the health informatics field could provide a significant positive impact on the healthcare field.

KI Students holding their prizes. From left to right: Daniel, Aulia, Tom, Mark
The champions. From left to right: Daniel, Aulia, Tom, Mark. Photo credit: Adintya

How’s your decision-making process going regarding applying at KI?

Speaking of decision making, how is it going for you on your registration process at universityadmission.se? Have you decided on what course you will be applying for? I have been in your shoes.  I gathered all the information on the specific programme that I was interested in since I had found a gap of need in the healthcare management field that I was working in. The gap finally drove me into deciding to apply for a health informatics programme at Karolinska Institutet. I hope that you too soon will be firm in your decision to apply for the programme that you have been expecting at KI. See you!

 

Contact me at:

email: winner.ng@stud.ki.se

LinkedIn: Winner Ng

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