Cost and Economic Benefit of Clinical Decision Support Systems (CDSS) for Cardiovascular Disease Prevention: A Community Guide Systematic Review

Details

• Alternative Title:
  J Am Med Inform Assoc
• Personal Author:
  Jacob, Verughese ; Thota, Anilkrishna B. ; Chattopadhyay, Sajal K. ; Njie, Gibril J. ; Proia, Krista K. ; Hopkins, David P. ; Ross, Murray N. ; Pronk, Nicolaas P. ; Clymer, John M.
• Corporate Authors:
  Community Preventive Services Task Force
• Description:
  Objective
  
  This review evaluates costs and benefits associated with acquiring, implementing, and operating clinical decision support systems (CDSS) to prevent cardiovascular disease (CVD).
  
  Materials and Methods
  
  Methods developed for The Community Guide were used to review CDSS literature covering the period from January 1976 to October 2015. Twenty-one studies were identified for inclusion.
  
  Results
  
  It was difficult to draw a meaningful estimate for the cost of acquiring and operating CDSS to prevent CVD from the available studies (n=12) due to considerable heterogeneity. Several studies (n=11) indicated healthcare costs were averted by using CDSS but many were partial assessments that did not consider all components of healthcare. Four cost-benefit studies reached conflicting conclusions about the net benefit of CDSS based on incomplete assessments of costs and benefits. Three cost-utility studies indicated inconsistent conclusions regarding cost-effectiveness based on a conservative $50,000 threshold.
  
  Discussion
  
  Intervention costs were not negligible but specific estimates were not derived because of the heterogeneity of implementation and reporting metrics. Expected economic benefits from averted healthcare cost could not be determined with confidence because many studies did not fully account for all components of healthcare.
  
  Conclusion
  
  We were unable to conclude whether CDSS for CVD prevention is either cost-beneficial or cost effective. Several evidence gaps are identified, most prominently the lack of information about major drivers of cost and benefit; the lack of standard metrics for the cost of CDSS; and not allowing for useful life of CDSS that generally extends beyond one accounting period.
  
  
• Subjects:
  Cardiovascular Diseases/economics Cardiovascular Diseases/prevention & Control Cost-Benefit Analysis Decision Support Systems, Clinical/economics Health Care Costs Humans
• Source:
  J Am Med Inform Assoc. 24(3):669-676.
• Pubmed ID:
  28049635
• Pubmed Central ID:
  PMC5538577
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Volume:
  24
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:9e19f8934d4d0a37b0287e1c2363c13653aeb5748d3feaa7b2bd2bb3cedf7354
• Download URL:
  https://stacks.cdc.gov/view/cdc/47224/cdc_47224_DS1.pdf
• File Type:
  [PDF - 471.52 KB ]