Web-based clinical decision support system for triage of vestibular patients.

Abstract

We sought to use a clinical decision support system (CDSS) to save costs and to improve scheduling of vestibular patients in an otolaryngology clinic. We conducted a concurrent review of 50 vestibular patients scheduled in the University of Missouri otolaryngology clinic with or without testing based on the outcome of a CDSS. The CDSS was implemented using Web-based technology. Charges incurred by the health care system through tests determined by the CDSS were compared with those incurred using the standard procedure of ordering hearing tests and electronystagmography for all patients. Thirty-nine tests were prescheduled using the CDSS. Twenty-five additional tests were ordered after the visit. The CDSS resulted in savings of $37,904.00 in charges to the health care system. The CDSS showed high specificity and variable sensitivity. A Web-based CDSS can be used to better manage and coordinate patient encounters. One important reason to use a CDSS in health care management is to lower costs.