More studies needed on CDS’ impact on inpatient costs

A remarkable gap persists on research assessing the impact of clinical decision support (CDS) on inpatient costs, according to a study published in BMC Medical Informatics and Decision Making.

Researchers from the Department of Biomedical Informatics, University of Utah School of Medicine screened 7,663 CDS intervention studies obtained on MEDLINE for a time period from 2008 through July 2013. Of those analyzed, 78.2 percent were controlled before-after studies and 15.4 percent were randomized controlled trials.    

The study found that:

• 70.5 percent of the studies resulted in statistically and clinically significant improvements in an explicit financial measure or a proxy financial measure;
• Only 12.8 percent of the studies directly measured the financial impact of an intervention, whereas the financial impact was inferred in the remainder of studies; and
• Data on cost effectiveness was available for only one study.

Researchers thus concluded that significantly more research is needed to determine the real impact CDS has on inpatient costs.

“[R]ecent analyses have found that health IT systems such as EHR systems are not having the anticipated benefits in cost reduction,” wrote lead author Christopher L. Fillmore, department of biomedical informatics, University of Utah School of Medicine, Salt Lake City, and colleagues. “This study adds to these concerns that the potential benefits of health IT and CDS are not well grounded in empirical evidence, with only 10 studies directly measuring costs and only one actually measuring cost-effectiveness of CDS for inpatient cost reduction.”