Chief Medical Information Officers

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Integrating Into Your EHR

The CDS tools are supported by most major EHR vendors. Ask your EHR vendor about integrating these tools into your system. If they are supported, determine the level of effort required by IT to customize, support, and maintain this investment.

To learn more about these CDS tools, please review the Office of the National Coordinator for Health Information Technology (ONC)/CDC Health Information Technology: Integration Framework.

For more information about public health infrastructure and clinical informatics, visit CDC’s Center for Surveillance, Epidemiology, and Laboratory Services.

Chief medical information officers (CMIOs) play a vital role in incorporating technology that is efficient and promotes safer opioid prescribing for patients in the context of managing chronic pain.

The CDC CDS tools are a pilot-tested service, and health systems can save time and effort by using these pre-vetted tools rather than investing in “homegrown” solutions or being dependent on vendor-specific solutions. Once integrated, CDS tools conveniently operate as components of EHR systems instead of stand-alone tools. These tools can be customized by IT staff to meet state requirements, local health department legislation, and the needs of each health system. Workflow integration is key for clinician adoption.

In the Clinical Setting

CDS tools support health systems by presenting clinicians with timely information to help them make decisions about patient care. These tools have been reviewed to ensure that the prompts are consistent with the intent of the underlying 2016 CDC Guideline recommendations. With security parameters already built in to protect patient information, CDS tools improve efficiency, cost benefit, and clinician and patient satisfaction.1

“Integrating the CDS tools has improved our overall ability to be more compliant.”

Eugenia “Genie`` McPeek Hinz, M.D., M.S., Associate Chief Medical Information Officer, Duke Health

Clinician Training

To help familiarize clinicians with the CDS tools, health systems should consider holding regular training sessions, sending weekly emails and reminders, and creating a frequently asked questions (FAQ) dashboard page with educational resources in the EHR. At Montefiore Medical Center, leadership developed a tip sheet explaining the different types of CDS tools, provided screenshots indicating where to access patient resources, and developed a presentation for primary care sites to use during clinician meetings. Montefiore developed E-Consult for Opioid Management, a resource that clinicians can use to ask questions to a team of physicians with expertise in judicious opioid prescribing.

“Our opioid stewardship members have been very enthusiastic supporters of a centrally developed CDS tool from a trusted source that was integrated with the workflow as tightly as the current CDS-Hooks [CDC’s CDS Tools] allowed.”

Nitu Kashyap, M.D., Associate Chief Medical Information Officer, Yale New Haven Health

Controlled Substance Agreement Case Study—Montefiore Medical Center

“Our CDS tools are linked to nationally recognized guidelines. We made additional adaptations to meet specific local policies.

For example, we designed our controlled substance agreement to include a written treatment plan, which is a New York State requirement for long-term opioid therapy. The plan includes the following sections for physicians to complete with their patients: goals for pain management and functional improvement based on diagnosis; a discussion on how opioid therapy would be tapered to lower dosages or tapered and discontinued if benefits do not outweigh risks; a review with the patient of the risks of and alternatives to opioid treatment; and an evaluation of risk factors for opioid-related harms.”

Sharon Rikin, M.D., M.S., Director of Ambulatory Quality Improvement, Montefiore Medical Center

1 Clinical Decision Support.

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