Clinical Informatics Tools
Clinical informatics tools are essential in modern healthcare. They enhance care delivery by assisting clinicians in decision-making, improving communication and patient outcomes, and streamlining clinical operations to increase efficiency.
Clinical Decision Support Interventions
The Centers for Medicare & Medicaid Services (CMS)’s Electronic Clinical Quality Improvement (eCQI) program defines clinical decision support (CDS) as "health IT functionality that provides persons involved in care processes with general and person-specific information, intelligently filtered and organized, at appropriate times, to enhance health and health care. CDS encompasses a variety of tools and processes to enhance decision-making in the clinical workflow. CDS is not simply an alert, notification, or explicit care suggestion. CDS helps clinical teams by supporting some routine tasks, warning of potential problems, or providing suggestions for the clinical team and patient to consider.”
Examples of CDS include:
- Computerized alerts and reminders for providers and patients
- Condition-specific order sets
- Focused patient data reports and summaries
- Documentation templates
- Diagnostic support
- Contextually relevant reference information
According to the 2012 CDS Implementation Guide, to add value, CDS tools should ideally deliver the following:
- the right information (evidence-based guidance, response to clinical need)
- to the right people (entire care team—including the patient)
- through the right channel (e.g., EHR, mobile device, patient portal)
- in the right format (e.g., order sets, flow-sheets, dashboards, patient lists)
- at the right step in workflow
Additional Resources on Clinical Decision Support
- The Five Rights of CDS (eCQI Resource Center)
- HTI-1 Decision Support Intervention Final Rule (ONC)
- Clinical Decision Support: More Than Just ‘Alerts’ Tipsheet (CMS)
- CDS Resources from the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Network
Resource Example:
The GOLDEN-BRIDGE II trial (2024) evaluated the effectiveness of a CDS system for stroke management in patients with acute ischemic stroke. Results were communicated at the American Heart Association’s 2024 International Stroke Conference, and publication is forthcoming.
Wearables and Asynchronous Device Technologies
Wearables and asynchronous device technologies are becoming increasingly common in neurological care. These devices or software programs allow neurology healthcare providers to care for patients outside of a traditional clinical setting.
Wearables
Wearables are technological devices that are worn on the body and perform a useful function for the wearer or a caregiver. Examples of wearables include smartwatches or adhesive patches containing sensors. Some wearables, called digital health technology (DHT), are connected to the internet through a mobile app and provide clinicians and patients with data on the patient’s health condition.
Asynchronous Device Technologies
Asynchronous device technologies transmit data to a health practitioner at a different time than when it is collected. For example, instead of a live video call, a patient can record a video of a medical event and then send the video to their physician via an encrypted data-sharing platform for asynchronous review.
| Neurological Condition | Uses of Wearable and Asynchronous Device Techology |
| Cerebrovascular diseases | Smartphones and smartwatches can detect a patient’s pulse and, in some cases, detect cardiac arrhythmia. These may be helpful for patients with TIA or CVA that are potentially caused by cardiac arrhythmia. |
| Cognitive impairment | Wearable devices can prompt patients with cognitive impairment and diabetes to check blood sugar levels. |
| Epilepsy |
Wearable devices and asynchronous technologies can detect certain types of seizures, document and transmit seizure data to medical teams, and alert others to emergency situations. |
| Sleep disorders |
Devices worn on the body or attached to a mattress can track sleep information and transmit it to medical teams. Other devices have been developed to improve sleep, but most require more study to determine effectiveness. |
Issues with Wearables and Asynchronous Device Technologies
While wearable technologies for neurological conditions are rapidly evolving, research on effectiveness and safety often lags behind. Before implementing a new device with patients, clinicians, health information technology staff, and legal departments must evaluate the privacy settings and data transfer requirements to ensure patient safety and compliance with government regulations for sharing patient data. Patients may also find new devices to be difficult to use, physically uncomfortable, or disruptive to their daily activities. It’s important to consider all of these factors before making a decision to recommend wearables and other technologies for a specific patient.