Clinician Decision Support Systems (CDSS) provide HCPs with
automated advice about best practice patient care, and have been
shown to effectively influence behaviour in terms of adherence to
guidelines and avoidance of drug errors. The Evidence Based Medicine
electronic Decision Support (EBMeDS) system is a CDSS that was
developed in conjunction with health care providers and successfully
implemented within SCI-Diabetes, the Scottish national electronic health record for diabetes. EBMeDS has
been 'live' to users within NHS Tayside and NHS Lothian since December 2013: evaluation found that use of
the EBMeDS system has resulted in a dramatic improvement in adherence to national guidelines, with modest
improvements in glycaemic control. Future work will aim to develop and implement additional rule-based
algorithms based on user feedback and roll out CDSS to all users of SCI-Diabetes across NHS Scotland.
The Scottish Diabetes Action plan emphasises the need for a 'person-centredness' approach to
support people with diabetes in managing their own condition. Diabetes care in Scotland relies
on a series of managed clinical networks supported by a national informatics platform - SCIDiabetes.
Regional and national audits are regularly published using this data on a series of quality
performance indicators (QPIs), which allow regional and international comparisons to be drawn.
Despite some encouraging trends in adherence to QPIs, there is clearly room for improvement.
To implement decision support scripts within the SCI-Diabetes system in NHS Tayside and West Lothian,
with a view to informing recommendations for a national decision support system. To demonstrate that
there are no unintended adverse effects, and to quantify changes in clinical processes and/or outcomes.
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