Healthcare Leadership Survey on EMR-Integrated Clinical Decision Support

We recently ran a healthcare leadership survey to see what executive leaders at hospital systems thought about clinical decision support (CDS) at their institutions.

We asked two simple questions.

  1. On a scale of 1 to 10, how effective do you find CDS in helping physicians diagnose and treat their patients?
  2. Are you currently developing any EMR-integrated CDS tools using the latest inter-operability standards?

The following results were very interesting.

The Power of Clinical Decision Support

Before we do that though, let's talk just briefly about CDS.

Physicians and caregivers use different forms of CDS for different clinical indications, with different levels of sophistication. The simplest might be a medical calculator, and the most complex is a dynamic clinical pathway that changes based on a patient's test results.

As new technology has emerged, CDS tools have been translated to computer-based software that streamlines and expedites the input-output process. More recently, newer interoperability standards (e.g. HL7, FHIR) open up greater levels of EMR integration, such as:

  • Intelligent triggering of a CDS pathway based on designated criteria
  • Single sign-on authentication for the provider
  • Runtime directly within the natural clinical workflow
  • The ability to pull clinical observations directly from the patient record
  • The ability to run complex algorithms using that data in a matter of seconds
  • The ability to write results directly back to the EMR
  • And more…

Healthcare Leadership Survey

So let's get to the survey. We polled over 1,000 healthcare leaders in the U.S. on the two questions about CDS tools, described in the first paragraph above. These leaders were CEOs, CFOs, COOs, CMOs and CIOs and CMIOs at healthcare institutions across the country.

At the close of the survey, we had over 100 responses coming all the way from west coast California to east coast North Carolina, with responses from states in between including Arizona, Texas, Michigan, Kentucky and several others. With 7-8% of all leaders polled submitting a response to the survey, the response rate was incredible.

CDS Survey Results

When asked whether they found CDS tools to be effective in treating patients, the overall average was a solid 7 out of 10. Not surprisingly, some responses were a 2 or 3, suggesting that perhaps the healthcare leader saw very little value in CDS, or perhaps in their experience to date, CDS simply wasn't getting the job done. On the other hand, several responses were 9 and 10 demonstrating a high perceived value at those hospital systems.

Although lacking statistical significance, we did see trends in slightly more favorable responses from executives in finance and operations; and slightly less favorable responses from CEOs and executives in marketing. It's hard to say why this is, but we intend to find out as we continue analyzing the survey data and reach out to more industry leaders.

When asked if they were developing CDS tools at their institutions, the average response was roughly 86% Yes and 14% No. Clearly healthcare leaders and their institutions are investing resources in developing CDS tools. Unsurprisingly, the institutions that responded No tended to be of a smaller size and perhaps with more limited resources. Our interpretation of the data is that, overall, there is a high degree of interest in the U.S. in developing and deploying clinical decision support solutions to improve patient care.

Closing Thoughts

At Impathiq, we see evidence-based, clinically validated pathways as the future for clinical decision support, and the future is now. These new tools will (and quite frankly, already do) shape how providers care for patients. The potential benefits to physicians, patients, hospitals, and our healthcare system overall are tremendous.

We are extremely excited about the emergence of new interoperability standards like SMART on FHIR. Our first solution HEART Pathway leverages these standards to provide EMR-integrated clinical decision support for patients presenting with chest pain. Built on IQ Engine, a scalable platform that enables plug-and-play deployment and realtime access to data insights, HEART Pathway has already improved outcomes for tens of thousands of patients and reduced healthcare costs by over $3M in a year at one hospital alone.

The possibilities for transforming healthcare through intelligent, EMR-integrated CDS are seemingly endless.

We'd like to offer our sincere thanks to all the healthcare leaders that participated in this survey. Our hope is that readers find these results valuable as they develop strategies to create and implement new CDS tools. Learn more about our mission at Impathiq and our approach to CDS here. Let's improve patient outcomes and reduce healthcare cost. Let's do it together.


It's important to note that the survey and results are by no means a scientific study. Admittedly, there is limited statistical power with a fairly small sample size. There is also likely a sampling bias such that more responses came from healthcare leaders that tend to have greater interest in CDS, and thus greater interest in participating in the survey. That being said, we believe it is a good start in understanding the importance and relevance of EMR-integrated CDS.