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The Centers for Disease Control and Prevention (CDC) stated in a 2017 report that 47 million unnecessary antibiotic prescriptions are written every year in the United States.

Though there are increasingly varying opinions on the issue, one thought remains the same among those in healthcare: we need to do better when it comes to medication. From over-prescribing to widely-varied pricing, there is always room for improvement, and antibiotic stewardship efforts continue to help the industry take steps in the right direction.

At EvidenceCare, we strive to improve the healthcare experience for everyone. Antibiotic stewardship is one of the main areas our tool helps clinicians and hospitals. In this fourth installment of our series on antibiotic stewardship, we’re looking at how clinical decision support tools can aid in antibiotic stewardship efforts.

How CDS can help

In a whitepaper published by Elsevier in 2017, Elsevier’s clinical support executive, Ken Stewart, RPh, is quoted as saying, “CDS is transforming from a ‘read this’ solution into a tool that provides direct ‘do this’ guidance to clinicians at the point of care.” This capability and functionality of clinical decision support can become an invaluable tool in antibiotic stewardship efforts.

One big way clinical decision support can aid in antibiotic stewardship, specifically evidence-based clinical decision support, is by providing the latest, most current information on different medications and treatment options. By making sure our protocols are as current as possible, we make sure that any possible antibiotic alternatives are provided. Additionally, we also make sure that an accurate diagnosis of symptoms is made more often, leading to proper treatment recommendations.

Secondly, clinical decision support tools like EvidenceCare can be used to tailor treatment to each patient by taking into account their medical history when making treatment suggestions. EvidenceCare’s Enterprise version syncs certain patient information automatically into a treatment protocol with them. This allows the tool to make recommendations based on medications they may currently be taking or have taken in the past.

This patient-specific portion of the tool also provides doctors with educational tools to help explain treatment decisions to patients and their families. Many doctors report feeling pressure from patients and family members to just prescribe an antibiotic, even when it may not be appropriate, and experiencing a lot of push back when they make alternative suggestions. Patient education tools help providers have conversations with patients and their families that can provide more understanding behind treatment decisions by further explaining certain conditions or treatments and using graphical explanations where appropriate. This helps them feel involved in their healthcare decisions and confident in the treatment the provider is suggesting, making them less likely to push back against the suggestion of a treatment plan that doesn’t involve antibiotics.

Now it can also be seen that as physicians with barely enough time to use the restroom, there isn’t necessarily time to walk through explanations with every patient that pushes back. However, the medical blog JournalFeed featured a study published by the Cleveland Clinic in a late 2018 post that found clinical encounters take only about 67 extra seconds when not prescribing an antibiotic to a patient versus prescribing one. The study focused only on appointments for acute respiratory infections, so while this may not consider all care settings and conditions, as the SpoonFeed post states “This study is important because it is one of the first to confirm our anecdotal sense that it would just be quicker to prescribe an antibiotic.” However, clinical decision support tools like EvidenceCare are designed to save clinicians those 67 seconds with features like EHR documentation acceleration and only providing the information needed in that moment. Those 67 seconds can now be spent working on antibiotic stewardship initiatives instead of scrolling through research or typing mindlessly into an EHR.

Finally, by incorporating medication guides and antibiotic-specific protocols, clinical decision support can give providers all of the information they need to make the best choice when they are able to choose between an antibiotic or another treatment option.  It can also guide clinicians in dosing, providing the latest information around each medication and its suggested dosage in their patient’s use case.

No replacement for clinical judgment

While no software, tool, or device in the world can replace a physician’s clinical expertise, clinical decision support is an invaluable tool when it comes to aiding in antibiotic stewardship efforts. EvidenceCare was designed by an emergency physician to do all of that and more right within a provider’s clinical workflow. We’re so passionate about it, we even provide all of our protocols (including our antibiotic guide and medication guidelines) for FREE. Try it for yourself at app.evidence.care.