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Electronic decision support systems at point of care: trusting the deus ex machina

Justin J Beilby, Andre J Duszynski, Anne Wilson and Deborah A Turnbull
Med J Aust 2005; 183 (2): . || doi: 10.5694/j.1326-5377.2005.tb06940.x
Published online: 18 July 2005

Australia needs a coherent long-term strategy for implementing these systems

Electronic Decision Support Systems (EDSS) have been defined as “access to knowledge stored electronically to aid patients, carers and service providers in making decisions on health care”.1 These systems provide relevant evidence-based information to both patients and health care providers at the time of making a decision about clinical management. More sophisticated systems provide a clinical decision based on information from a range of knowledge bases. EDSS are currently espoused as one of the keys to good quality and safe health care.2 With the current explosion of medical knowledge, most of which is stored electronically, both clinicians and consumers will increasingly require EDSS to assimilate and summarise information. Yet for most clinicians, there is a gulf between this ideal (see Box 1) and reality.


  • 1 Department of General Practice, University of Adelaide, Adelaide, SA.
  • 2 Department of Psychology, University of Adelaide, Adelaide, SA.



  • 1. National Electronic Decision Support Taskforce (NEDST). Electronic decision support for Australia’s health sector. Canberra: Australian Government Department of Health and Ageing, 2003.
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  • 4. National e-Health Transition Authority website. Available at: http://www.nehta.gov.au (accessed Jun 2005).
  • 5. GPCG Standards Work Plan. Available at: http://www.gpcg.org/publications/docs/StandardsWorkPlanMay2003.pdf (accessed Jun 2005).
  • 6. Rousseau N, McColl E, Newton J, et al. Practice based, longitudinal, qualitative interview study of computerised evidence based guidelines in primary care. BMJ 2003; 326: 314-322.
  • 7. National Health Service. Health Informatics: community. GPs to get wider selection of computer systems. Available at: http://www.informatics.nhs.uk/cgi-bin/item.cgi?id=1258 (accessed May 2005).
  • 8. Garg A, Adhikari N, McDonald H, et al. Effects of computerised clinical decision support systems on practitioner performance and patient outcomes. JAMA 2005; 293: 1223-1238.
  • 9. Kawamoto K, Houlihan C, Balas EA, Lobach D. Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success. BMJ 2005; 330: 765. Epub 2005 Mar 14.
  • 10. Turnbull DA, Beilby JJ, Ziaian T, et al. Disease management for hypertension: a pilot cluster randomised trial of 67 Australian general practices. Disease Management and Health Outcomes 2005. In press.

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