Clinical decision support systems (CDSS) are designed to assist clinicians at the point of care on decision making tasks. Examples of applications of clinical decision support include:
Most CDSSs consist of three parts:
Using a combination of SNOMED CT techniques, including mapping, subsets, subsumption and defining relationships, SNOMED CT helps to support the inference engine in determining the appropriate rules to execute.
For example, Kaiser Permanente's HealthConnect system uses SNOMED CT to support efficient translation of its business rules into decision support rules. The National Board of E-Health in Denmark is developing a centralized decision support service based on the Danish SNOMED CT drug extension, which utilizes the hierarchical and defining relationships of SNOMED CT.
A number of commercial tools also use the capabilities of SNOMED CT to implement Clinical Decision Support. For example, Cambio's COSMIC tool binds GDL (Guideline Definition Language) rules to SNOMED CT concepts to support the triggering of appropriate rules. Allscript's Sunrise InfoButton™ feature provides relevant medical reference content to clinicians wherever patient care decisions are made, by using SNOMED CT encoded patient problem lists and medication data to query third-party medical content. The Epic system provides decision support alerts (called 'Best Practice Advisories'), which are able to use the SNOMED CT hierarchy to help define their criteria. And First DataBank delivers clinical decision support solutions linked to SNOMED CT, primarily to detect safety issues arising from certain combinations of medications, diagnoses and drug adverse reaction histories.