EHR Clinical Decision Support Functions Linked to Better Care Quality

November 3, 2014 in News

Meaningful use standards that require clinical decision support functions could significantly improve quality of care, according to a study published in the American Journal of Managed Care, Health IT Analytics reports.

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments.

Details of Study

For the study, researchers analyzed data from the 2006 to 2009 National Ambulatory and National Hospital Ambulatory Medical Care surveys on adult primary care visits to practices that met the requirement for Stage 1 of the meaningful use program. These practices had EHR systems with at least one of five CDS functions:

  • Electronic problem lists;
  • Lab result reports;
  • Notifications for out-of-range labs;
  • Reminders for preventive care; or
  • Warnings for drug interactions.

The researchers then divided the visits into three categories:

  • Visits to practices with all CDS functions enabled;
  • Visits to practices with at least one CDS function disabled; and
  • Visits to practices with at least one missing CDS function (Bresnick, Health IT Analytics, 10/31).


The study found that 86% of patients who visited primary care clinics with all five types of CDS functions had controlled blood pressure, compared with 82% of patients who visited clinics with at least one missing function and 83% of patients who visited clinics that had disabled at least one function.

Further, researchers found that:

  • CDS functions were associated with blood pressure control and fewer visits for adverse drug events;
  • CDS functions were associated with better performance on indicators of quality of care and clinical decision support functions related to such quality measures (Mishuris et al., AJMC, 10/28); and
  • Decisions to disable CDS functions were associated with reduced quality of care improvements (Health IT Analytics, 10/31).

However, the researchers said they were unable to determine an association between disabling particular CDS functions and cancer screening, health education or influenza vaccinations because of limited data (AJMC, 10/28).


The researchers said, “Overall, meaningful use standards that include [CDS functions] appear to have a significant positive effect on some national quality-of-care indicators and health outcomes.”

They added, “It will be important to evaluate the evolving impact of meaningful use as the stages continue to be more widely implemented and better integrated with care processes; we anticipate further gains in healthcare quality indicators and outcomes as a result” (Health IT Analytics, 10/31).

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