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Chapter 1  -  Approaching Clinical Decision Support in Medication Management



 CHAPTER 1 SECTIONS 
  1. Introduction
  2. Overview of CDS Five Rights
  3. Applying CDS to Medication Management
  4. Types of CDS Interventions
  5. How Key Terms Are Used in this Book
  6. Typical State of Medication Management Today
  7. A Vision for Optimal, CDS-Enabled Medication Management
  8. A Peek at the Literature on Medication Use and CDS
  9. Concluding Comments
  10. References

OVERVIEW OF CDS FIVE RIGHTS

CDS interventions can be applied throughout the medication management cycle to optimize medication safety and other pertinent outcomes. A useful framework for achieving success in this effort is the “CDS Five Rights” approach. This should not be confused with the Five Rights of medication use, which speak to ensuring that the right patient gets the right drug at the right dose, via the right route, and the right time. [1]

The CDS Five Rights model states that we can achieve CDS-supported improvements in desired healthcare outcomes if we communicate:

  1. The right information: evidence-based, suitable to guide action, pertinent to the circumstance
  2. To the right person: considering all members of the care team, including clinicians, patients, and their caretakers
  3. In the right CDS intervention format: such as an alert, order set, or reference information to answer a clinical question
  4. Through the right channel: for example, a clinical information system (CIS) such as an electronic medical record (EMR), personal health record (PHR), or a more general channel such as the Internet or a mobile device
  5. At the right time in workflow: for example, at time of decision/action/need

For each step in the medication management process, one can consider how to apply these CDS Five Rights to ensure that the step is negotiated with optimal effectiveness, safety, and resource use. Chapters 3 through 5 will explore in detail how to address these parameters to achieve specific objectives associated with medication management, such as decreasing drug-drug interactions (DDIs), and supporting proper drug selection and dosing.



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