Decision Support Systems for Improving the Quality of Medical Care

The successful delivery of medical care is a complex outcome that depends on multiple factors. Structural factors include the setting in which care takes place and related infrastructure that facilitate the care processes. The actual processes of medical care are defined by the completeness of the diagnosis and appropriateness and continuity of the resulting patient treatment. These factors are also highly dependent on valid, accurate, complete and reliable data collection and the use of that data to build models and systems to support the decision making processes involved. This presentation describes the computational, data communication, organizational and managerial components of a networked decision support system to improve medical care in a distributed healthcare system serving diverse patients. After data validation and cleaning, a statistical risk model is created that adjusts for the regional patient mix, loads and available structures of care. Using the model the system produces: (1) summary reports comparing patient outcomes over multiple periods, (2) dashboards to convey up to date status on utilization and outcomes and (3) a decision calculator for clinicians to calculate the riskiness of patient conditions - all intended to drive data driven decision making in the distributed healthcare system. Details of the data collection, data processing and system outputs and their use in medical decision making by various stakeholders -policy makers, regional hospital administrators, medical department chiefs and clinicians are illustrated and organizational/managerial best practices are presented. These practices coupled with the communication technologies have implications for distributed DSS practitioners and researchers.