2017 - Competency KM-E

Table of Contents

<< Move to KM-D

>> Move to KM-F

Competency E: The practice incorporates evidence-based clinical decision support across a variety of conditions to ensure effective and efficient care is provided to patients.

KM 20 (Core): Implements clinical decision support following evidence-based guidelines for care of (Practice must demonstrate at least four criteria):

To get credit for this, the practice must identify conditions, source of guidelines, and evidence of implementation

The practice utilizes systems in its day-to-day operations that integrate evidence-based guidelines (frequently referred to as clinical decision support [CDS]). CDS is a systematic method of prompting clinicians to consider evidence-based guidelines at the point of care. CDS encompasses a variety of tools, including, but not limited to:

• 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.

Although CDS may relate to clinical quality measures, measures alone do not achieve the broader goals of CDS.

• A. Mental health condition.

The practice uses evidence-based guidelines to support clinical decisions related to at least one mental health issue (e.g., depression, anxiety, bipolar disorder, ADHD, ADD)

Description	Example/Screenshot/Documentation	Source	Date Added
Example of using ADHD as an important condition in PCC EHR	Using ADHD as an important condition	PCC	09/06/17

• B. Substance use disorder.

The practice uses evidence-based guidelines to support clinical decisions related to at least one substance abuse issue (e.g., illegal drug use, prescription drug addiction, alcoholism).

• C. A chronic medical condition.

The practice has evidence-based guidelines it uses for clinical decision support related to at least one chronic medical condition (e.g., asthma, cardiovascular disease, diabetes, hypertension). The AAP has recently published new hypertension guidelines. Included is a screening tool that can be used for the identification of children and adolescents who need further evaluation of their BP starting with repeat BP measurements

• D. An acute condition.

The practice uses evidence-based guidelines to support clinical decisions related to at least one acute medical condition (e.g., allergic rhinitis, bronchiolitis, influenza, otitis media, pharyngitis, sinusitis, urinary tract infection).

• E. A condition related to unhealthy behaviors.

The practice uses evidence-based guidelines to support clinical decisions related to at least one unhealthy behavior (e.g., obesity, smoking).

• F. Well child or adult care.

The practice uses evidence-based guidelines to support clinical decisions related to well-child or adult care (e.g., age appropriate screenings, immunizations).

Description	Example/Screenshot/Documentation	Source	Date Added
Example of using well child care as an important condition in PCC EHR	Using Well Child Care as an important condition	PCC	09/06/17

Stay tuned for examples of the 4th edition of Bright Futures soon to be incorporated into PCC EHR.

• G. Overuse/appropriateness issues.

The practice uses evidence-based guidelines to support clinical decisions related to overuse or appropriateness of care issues (e.g., use of antibiotics, avoiding unnecessary testing, referrals to multiple specialists). The American Board of Internal Medicine Foundation’s Choosing Wisely campaign provides information about implementing evidence-based guidelines as clinical decision support http://www.choosingwisely.org.