Clinical decision support (CDS) is a tool for providing medical professionals and patients with access to the most current guidelines and recommendations to inform the delivery of patient care. Best practices for STI recommendations shift regularly to accommodate the newest science—for example, to reflect the rise of antibiotic-resistant gonorrhea infections. The adoption of electronic health records (EHRs) and the use of standards has allowed for implementation of automated real time CDS solutions that place the most up-to-date recommendations in the hands of clinicians at the time of care. CDS solutions can come in many forms such as alerts, questionnaires, forms, specialized order sets or links to recommended guidelines.

PHII CDS pilot

In collaboration with CDC and a vendor partner, PHII is conducting a CDS pilot to focus specifically on gonorrhea. The CDS solution will address clinicians’ need to access to the most current guidelines and recommendations to ensure patients with gonorrhea symptoms receive effective and timely care to live safer, healthier lives, and to protect public health. The pilot’s goal is to deliver patient-specific clinical decision support at appropriate times during the point of care that reflects authoritative public health science.

PHII plans to pilot an integrated, scalable, standards-based CDS solution to provide gonorrhea treatment recommendations that adhere to the latest CDC guidelines. The solution will be EHR-agnostic and will be designed to simplify information delivery and integrate into existing care delivery, leveraging tools and standards that are widely deployed, and which make use of open-source and open-standards. The solution integrates with EHR systems as part of the clinical workflow, and will be centrally managed and easily updated for broad distribution of authoritative public health science to improve patient outcomes.

Background of previous CDS work

PHII is piloting the CDS pilot in collaboration with the CDC, building on a strong foundation laid by several previous years of multi-partner planning. In 2019, PHII developed a proof of concept design for a gonorrhea CDS tool within a clinical workflow in partnership with Apervita, AllianceChicago and Brigham and Women’s Hospital. In 2020, OCHIN and Codman Square joined the partnership to assist in designing a CDS solution that includes a sexual history data capture form, a best practice advisory, an enhanced STI order set and a documentation template. A resulting pilot of this CDS solution ran for 12 weeks between August and November 2021.

After the 2021 pilot, PHII partnered with Lantana Consulting to conduct an environmental scan and develop business and systems requirements for a new standards-based CDS solution for gonorrhea treatment; this work will go on to directly inform the upcoming one-year pilot planned for 2022.