Healthcare organizations are drowning in digital complexity.  On average, Phrase Health customers each manage nearly 400 alerts, 678 order sets, and over 2,000 documentation templates. The explosion of EHR content is contributing to a staggering $265 billion problem in clinical variation. 

Dr. Tatyan Clarke, Associate Chief Medical Informatics Officer at Temple Health, and Dr. Marc Tobias, CEO and founder of Phrase Health, tackled these challenges head on in a webinar earlier this month entitled, “Reducing Variation: Strategies to Address Clinical Decision Support Burden." 

The conversation revealed a sobering truth – clinical decision support (CDS) systems designed to improve patient care are often difficult to manage and, as a result, become barriers to optimal treatment.

Dr. Clarke, emphasized a fundamental principle: "Good design is an act of empathy." Her approach centers on making the “right clinical choice the easy choice,” recognizing that when systems are difficult to use, providers simply won't engage with them effectively.

Rethinking decision support

The webinar challenged traditional thinking about CDS systems. Rather than viewing them as just alerts, the experts demonstrated how decision support encompasses every tool with embedded knowledge that clinicians interact with – from order sets requiring extra clicks to poorly designed validation messages. Dr. Tobias, drawing from his clinical informatics fellowship at Children's Hospital of Philadelphia, highlighted how highly targeted alerts can create unexpected burdens when not monitored over time.

Temple Health's approach offers a compelling case study. With 599 active alerts and 577 order sets (counting only content used by clinicians within the past year), they've developed sophisticated governance structures that prioritize both clinical safety and user experience. Their secret? Treat nudges like billboards with five-word headlines and ensure every intervention is actionable.

A governance game-changer

Perhaps the most valuable insights centered on governance and sustainability. Dr. Clarke outlined Temple Health's CDS leadership committee structure, where cross-functional teams including informatics, nursing, pharmacy, and physician champions collaborate to solve core problems rather than simply implementing requested features. This "art of saying no" – or rather, giving people what they need instead of what they ask for – has proven crucial for maintaining system effectiveness.

The webinar emphasized five key principles for sustainable CDS programs: design with empathy, establish empowered stakeholder governance, focus on solving core problems, maximize value while minimizing burden, and measure quantifiable impact. These aren't just theoretical concepts – they're practical strategies backed by measurable outcomes.

What’s next

The webinar also referenced new research published in Applied Clinical Informatics titled "The Burden of Highly Targeted Alerts," co-authored by Dr. Clarke and Dr. Tobias, providing additional data-driven metrics and insights into this critical issue.

For healthcare leaders struggling with CDS content optimization, executive buy-in challenges, or simply wondering where to start with limited resources, this webinar offers concrete answers. The recording provides detailed strategies for building business cases, implementing governance structures, and preventing systems from becoming cluttered again after optimization.

Access the full on-demand recording and additional resources at AMIA and find more resources on transforming organization's approach to clinical decision support at phrasehealth.com/resources