Decision support is a key objective within the Digital Health and Care Strategy and a prime enabler of Realistic Medicine, because of its potential to transform delivery of health and care. Decision support tools use research evidence, practitioner expertise, people’s lived experience and a range of artificial intelligence technologies to improve decisions by all partners in health and wellbeing. The evidence shows that decision support can be a key enabler of safe, effective, person-centred care. Decision support tools have the potential to strengthen self-management and enable people to live well at home for longer. They can enable timely and appropriate referral across agencies; support remote and rural care; improve triage in accident and emergency and empower communities to meet the goals of public health reform and social care reform.
The Digital Health and Care Institute, in collaboration with the Scottish Government Digital Health and Care Division, has now launched the next research and development phase of the innovative decision support programme to help deliver these benefits.
As a springboard for this new phase, the decision support programme has released the Beta-version version of the Right Decision Service .This website supports staff to more easily find and create a broad range of decision support tools for self-management, shared decision-making and frontline care.
These tools use information, expert systems based on evidence and practitioner expertise, and other artificial intelligence tools, to prompt swift and appropriate action for high quality care focused on the individual needs of each patient. The tools are easily accessible on-line and via mobile apps and work is underway to embed them in electronic health record systems. The tools are designed to open digital standards to enable future integration with developing national health and care platforms and other relevant data and information systems.
Earlier groundwork with a number of partners in Government and health and social care (listed below) has shown that these tools can deliver up to a 9-fold improvement in screening for diabetes related complications. Other early Right Decision Service tools have been developed for safe prescribing of antibiotics, shared decision-making with people living with multiple conditions, and care at home staff delivering palliative and end of life care.
Key areas of focus for this new stage of research and development, initially planned from September 2019 to March 2020, include:
- Expanding mobile self-management and shared decision making tools for people taking multiple medicines. This will include a focus on design to support vulnerable groups who have challenges in digital and health literacy.
- Testing integration with primary care electronic health records to empower practitioners and people taking multiple medicines, and those living with chronic pain, to engage in well-informed and joint decision-making;
- Testing the benefits of decision support on managing demand and capacity in requests for radiology services.
- Supporting early adopter Boards and regions in the West and South East of Scotland to deliver mobile and web-based handbooks, guidance and clinical pathways.
- Showing how algorithms created from big data about people with co-morbidities (COPD and Congestive Heart Failure) can improve predictions about outcomes and help practitioners to tailor care plans accordingly.
Decision support covers a broad range of technologies and perspectives, and is fortunate in having many active clinical and management champions. A key outcome from this new phase will be an inclusive coordinating framework which supports widespread engagement based on a shared vision, standards and principles.
While this programme is still in its formative and iterative stages of development, it will play a key role in defining future direction of travel. This will help us to deliver the full potential of decision support in putting the person’s needs and values at the centre of interactions with professionals and the health and social care system.
Project partners with DHI and Scottish Government Digital Health and Care:
- Realistic Medicine, Primary Care, Effective Prescribing and Therapeutics, and the Modern Outpatient Programme.
Health and social care:
- NHS Greater Glasgow and Clyde, NHS Ayrshire and Arran, East Ayrshire Health and Social Care Partnership, NHS Lanarkshire, South Lanarkshire Health and Social Care Partnership, NHS Tayside, Midlothian Health and Social Care Partnership, and the Scottish Radiology Transformation Programme.
- The ALLIANCE, Macmillan Cancer Support