Clinical decision support

Turning Referential Knowledge into Executable Knowledge

May 18, 2018

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By Chris O’Connor

This blog is Part 2 in a 3-Part series on the Evolution of Order Sets.

In their simplest form, you may think that Order Sets are a checklist of medical knowledge in the form of orders (based on extensive research, piled up nicely into easily accessible, modular sections). However, there really is much more to Order Sets!

An Order Set is a representation of executable knowledge, and when used to its full potential, it can have far-reaching impact on the state of medical care. Executable knowledge is knowledge in the form of an individual’s work output. For hospital-based physicians and many allied health professionals, two key types of work are ordering and documentation. Tools such as Order Sets can support best practice ordering and team efficiency, but they also have other indirect benefits, outlined below.

Connectivity

Order Sets do not stand on their own. Instead, Each Order Set is one part of a greater whole that connects to hundreds of other Order Sets in a large network of hospitals. They bring together thousands of clinicians and give them access to a greater stream of knowledge. This connectivity is what enables the creation of innovative approaches to the implementation of best practices in diverse care environments.

The evidence-based best practice library is used by organization as a starting point for Order Set development, and is built in partnership with Canadian specialty societies, professional associations, and other groups. To help this process, Think Research works directly with this ecosystem to ensure that the evidence includes the best content and that it meets the unique needs of the Canadian healthcare system. This kind of connected approach to creating Order Set recommendations is something that is unique to Think Research, along with local adaptation and integration into hospital and regional workflows.

Order sets provide three types of data:

Content Data

Each organization customizes the reference Order Sets to meet their local needs. Accessing network Order Sets allows one a holistic view of how health care organizations are adopting best practices. The Think Research network provides this information at scale in real time.

Utilization Data

For organizations using advanced CPOE systems for ordering or the EntryPoint platform, Think Research can provide order item level and clinician level data on Order Set completion.

Outcome Data

The utilization data can then be combined to provide insights on key outcomes such as LOS, readmission rates, patient care and length of stay. For example, beyond just prescribing amoxicillin for pneumonia, data can reveal how well the amoxicillin worked, how long the patient stayed at the hospital, how many times they came back, if they had any secondary complications, and whether they required further treatment. Multiply that by the number of clinicians who treated patients with pneumonia and then imagine the amount of data available to help understand how to improve patient care! This level of analysis can assist each hospital within the network to improve their recommendations and also view what other hospitals are doing to provide better care.

These added benefits of connectivity and data help to differentiate Think Research’s Order Sets, and provide added value to our healthcare system. Stay tuned for the third blog in this series on the evolution of Order Sets.

Missed the first blog in this series? Read it here.

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