Decision Support Whitepaper

What is Decision Support?

Decision support is software that guides employees into making quality decisions in support of an organization’s goals. It is predominantly used when the knowledge domain is complex and the decision-making process is difficult.


Why is decision support important for Health Care?

A Clinical Decision Support system helps clinicians in assessment, diagnosis, and giving appropriate and safe case-specific advice. It is important for improving patient outcomes and delivering higher quality care for busy clinicians and is a central component of Electronic Health Records  and Healthcare CRMs HealthCare CRMS.


Decision support helps anyone support navigate complicated decisions. It is crucial to simplifying and improving the work of your teams.



What is an Expert System?

An expert system is a type of artificial intelligence application. It embeds knowledge and decision criteria from experts in the field into software for purposes of guiding non-experts to the right path. Experts even use it to maintain quality while making quick decisions. An expert system combines multiple types of decision support to assist users through many types of hurdles.

How does an Expert System help?

An expert system takes complicated rules, knowledge, and processes and packages them into an easy experience. The knowledge that goes into these systems can take years to hone and might even be too extensive and complicated for a single person to ever master. For example, no single person may have a full grasp of the following:


Expert System


Navigating these is daunting for staff, much more patients. However, all of these can be encoded into CareDesk with easy guidance for their existing users and honed over time.


(click to see a visual explanation)

Before Expert System Use –
New requirements come in that requires a change to process. Say a new provider is added, there is a change to insurance, procedure requirements are updated, or any new process is updated. Operations has to undertake the following steps:




Artboard 19@3x


Update documentation


Artboard 13@3x-1Update training


Artboard 11@3x-1


Communicate the change to staff


Artboard 23@3xRe-train employees in the new process


Artboard 21@3x

Get validation of understanding from the staff

Artboard 30@3x-1Undertake QA to validate the change is properly being implemented




After Expert System Use –
New requirements come in that requires a change to process. Operations has to:

Artboard 19@3x  Update the expert system


Based on this:

Interface and instructions automatically change

Employees are prompted to the new workflow in real time

QA capabilities are built into the system




Data collection and scripting is robust and set to respond interactively to feedback from the expert system. It supports 10 question types:Artboard 27@3x

  Artboard 19@3xCheckbox (Yes/No) Artboard 30@3x-1Small Text box  
  Artboard 11@3x-1Checkbox (multi-selection) Artboard 24@3xLarge Text box  
  Artboard 21@3xRadio button (single-selection) Artboard 16@3x-1Link to another protocol  
  Artboard 13@3x-1Likert/thermometer (single-selection) Artboard 26@3xCalculated field (visible or hidden)  

Artboard 23@3xDropdown (single-selection)


Artboard 18@3xAction button  



Decision trees can be tailored to any scenarios you need. Apart from data input, branching can be determined by situational factors. Some of these situation factors are:

Artboard 28@3x

  Artboard 19@3xSymptom Checker result

Artboard 30@3x-1Contract Site

  Artboard 11@3x-1Patient Age (or estimate)

Artboard 24@3xCaller relationship to the patient

  Artboard 21@3xPatient Sex

Artboard 16@3x-1Time of day, day of week, or day of year


Artboard 13@3x-1Contract

Artboard 26@3xType of interaction: telephone, web survey, chat, SMS, etc.


Artboard 23@3xContract service level




The rules engine is built to work with clinical concepts and actionable results. It supports multiple inference types depending on the need – forward, backward, and hybrid.

Event monitor looks for events on which a decision should be made. An event is something that occurs in the software. Here are some sample events:

Artboard 29@3x

  Artboard 19@3xInterview disposition is ED

Artboard 23@3xEncounter is submitted

  Artboard 11@3x-1Patient submits a question online

Artboard 30@3x-1Encounter is forwarded to a queue

  Artboard 21@3xTimer expires

Artboard 24@3xEncounter is closed


Artboard 13@3x-1A field is changed





When an event occurs, the rules engine can check for matching conditions, launch a decision tree, or trigger further actions.

Expert Knowledge Bases include custom content, as well as licensed content.

Harvard Health Publishing content is licensed for NLP Symptom Screening

Schmitt-Thompson Clinical Content is licensed for Nurse Triage

Results of the expert system include Care Advice, Dispositions or Health Education. It can also result in software automation including:



Artboard 19@3x


Encounter handling (opening, forwarding, closing, setting status, etc.)


Artboard 13@3x-1Present alerts or messages to the user


Artboard 13@3x-1Updating fields (changing outcome, updating priority, etc.)


Artboard 23@3xAutomate communication via email, SMS,


Artboard 21@3xPrompt for scripting or new workflows (see “Proactively Offer Services” in BUSREQ DENSUP-1-2 as an example)

Artboard 30@3x-1Fax, Paging, or EHR messages/tasking More…




Expert System Products

CareDesk contains several pre-packaged expert system products, including 
Nurse Triage for clinicians
Symptom Checker for non-clinicians
and more! Contact us for more information.