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Clinical Decision Support System (CDSS) for Pregnant Patients

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In the mission of health practitioners and nurses to assist pregnant women and

establishing safe maternity services, inevitable barriers while helping pregnant women are

experienced, among them errors associated with ambiguity of professional handwriting and

dictation of medication orders. These obstacles can be referred as clinical issues that nurses and

other medical counterparts encounter in the quest of trying to establish safe maternity services. In

recent days, pregnancy have been associated with several risks that need to be identified and

managed. This has led to it being identified as a global issue. Having noted the issue,

identification and management of pregnancy associated risks requires embracing a Computerized

Provider Order Entry (CPOE) system (Moon & Galea, 2016).

Computerized Provider Entry (CPOE) denotes to the progression of a healthcare

professional entering and conveyance medication guidelines as well as treatment procedures

instructions electronically through computer application in the place of handwritten or general

paper charts (Amiri, Rahimi, & Khalkhali, 2018). The use of CPOEs instead of traditional paper

chats is accompanied by a number of benefits. CPOE promotes patient’s safety through reduction

or even elimination of medication errors. Healthcare providers are in a position to transmit

medication orders electronically making the method quick. CPOEs improve efficiency while

submitting medication to pregnant women (Eke, 2017).

Integration of CPOEs with Clinical Support Systems (CDSSs) and Electronic Health

Records (EHRs) have resulted to additional advanced patient safety and efficient care. CDSS is a

software that examines data to assist a healthcare provider formulate accurate and effective plans

in the practice (Nallas & Moon, 2016). This application is essential in achieving full benefits of

EHR and CPOE. In CDSS a variety of computerized and non-computerized tools and

interventions are present supporting formulation of high quality clinical decisions (Nallas &
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Moon, 2016). Generally, decisions by healthcare professionals on pregnancy are often made

during direct patient care, and multidisciplinary meetings. This have a meaning that various

pregnancy decisions are made within minutes or hours and all depend with on the health

practitioner having medical knowledge available at the time of the decision.

While dealing with a pregnant woman, decisions need to be strongly determined by

experience and knowledge of the profession (Eke, 2017). A consideration of patient’s condition

taking place before medication have to be observed. It is therefore necessary for a healthcare

provider to overlook patient’s current conditions as well as changes within the medication

period. Application of a computer avails all data making it possible to notice changes outside the

scope of the professional and changes for the individual patient within normal limits (Eke, 2017).

A clinical decision support system for pregnant patients

The intention of this system is to arrange for risk assessment and risk management for

pregnant women and engage them at the earliest stages of their pregnancy in the identification

and management of pregnancy associated risks. It can complement calculators for maternity risk

assessment. The system can be divided into three major parts; user management, rules running,

and care plan administration. User management allows storage and retrieval of patient and health

provider details. Rules running enhances storage and retrieval of questions to display in the

patients’ form as well as rules necessary for care management plans generation.

Guidelines Copyreader

Under guidelines copyreader, a healthcare provider visually edit the logic behind the

generation of care plans for pregnant patients. The editor allows modification of list of questions

required as inputs and necessary to change the way of care plans based on the answers. A
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number of questions emerge to be impossible to modify or delete, those that identify a patient

uniquely such as age, height, weight, but the responsible healthcare provider can add other

questions. New questions can be formulated in numbers as well as string that are selected from a

list of possible values. Questions have to be grouped into sections such as appointment booking,

labor ward in a way that sections can be added or created and delete them. In reference with the

patients’ questions, the system can generate quality care plans. The care plans give room for

more creation, deletion and modification. These care plans entails of; name, intermediate

calculations in the event of answers aggregation before use, rules to be followed aligned with a

test condition, list of evidence links behind the care plans generation, and a list of information

links for the patient to access.

Patient outlook

After creation of rules, the set rules can be implemented in the patient view for generation

of individual care plans. Availing patient view in web interface as well as mobile application for

healthcare providers and patients, allows healthcare provider update all the information to

display as the patient have a read-only access. The patient view can be divided into two sections.

One section to display questions as dropdown options or number inputs and the second section to

display care plans. Defaulting plans should be displayed with a shouting color for quick

identification of required actions. Evidence and information links should be precisely shown.

This system comprises of numerous guidelines that are subject to change. In addition, it is

time consuming for healthcare provider to compile the required information and keep on

updating the information. Fellow clinicians can adopt and implement this system for proper

supervision and management of a large number of pregnant patients. Embracing this system

require adequate dedication to frequent adjustments intended to provide updated information. For
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proper running of this system, health providers and patients need to observe accuracy in details

provision to eliminate chances of errors and information loss. Feeding inaccurate information

may result to availing information links that end up being of no help to the patients since the

identified risks are a far different from the reality. Identification and supervision of pregnancy

associated risks is necessary for appropriate treatment of pregnant women.

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References

Amiri, P., Rahimi, B., & Khalkhali, H. R. (2018). Determinant of successful implementation of

computerized provider order entry (CPOE) system from physicians’ perspective:

Feasibility study prior to implementation. Electronic Physician, 10(1), 6201-6207.

doi:10.19082/6201

Eke, A. C. (2017). How does continuous support affect outcomes for pregnant women during

childbirth? Cochrane Clinical Answers. doi:10.1002/cca.1851

Moon, J. D., & Galea, M. P. (2016). Overview of clinical decision support systems in

healthcare. Improving Health Management through Clinical Decision Support Systems,

1-27. doi:10.4018/978-1-4666-9432-3.ch001

Nallas, R., & Moon, J. (2016). Integration of automation and clinical decision support

systems. Improving Health Management through Clinical Decision Support Systems,

165-185. doi:10.4018/978-1-4666-9432-3.ch008