Most EMRs, despite the attention and money spent on them, have yet to fulfill their potential to provide right-time and right-place clinical decision support (CDS). CDS needs to be presented to the provider in the EMR when he is placing orders, and automatically incorporates whatever data are known about the patient (age, sex, etc) to maximize effectiveness. This is a key way for EMRs to compensate for the reduced productivity that they (almost) invariably cause.

EvidenceCare (http://evidencecare.com), created by an emergency physician, has developed a next-generation CDS tool for the most critical conditions like sepsis, stroke, ACS, and PE in cooperation with domain experts in emergency medicine. Not only can the decision-support tool be integrated into the EMR to provide just-in-time recommendations, but it can also assist the provider with properly documenting his clinical decision-making.

The program walks providers through a series of rules that define appropriate care and illustrates the risks related to the decisions made. Unlike other CDS tools, the company's interface is highly intuitive and delivers only the evidence and guidelines relevant to a specific patient's conditions.

EvidenceCare includes a patient education module, which supports shared decision-making and helps providers improve the patient's trust in the decision. It also includes an integrated Antibiotic Advisor, which promotes antibiotic stewardship, and a CME tracker that allows docs to earn CME for the time spent using the system.