Do DSSs Improve Process of Care?
Among the DSSs designed to improve process of care, those aimed at preventive interventions and drug administration have been the most successful. In the McMaster review, 14 of 19 studies of DSSs for preventive services found a positive effect on process of care.6 A meta-analysis by Shea and colleagues14 found improvement in rates of vaccination, improvement in rates of screening for breast and colorectal cancer, and a reduction in risk factors for cardiovascular disease. (An increase in rates of screening for cervical cancer did not reach statistical significance.) These studies provide convincing evidence that DSSs can improve the delivery of preventive services. Of the 15 studies in the McMaster review that assessed the use of DSSs for drug dosing, 6 of 8 that evaluated administration of intravenous medications (e.g., theophylline, lidocaine, and heparin) found beneficial effects. Seven evaluated DSSs for warfarin dosing, but the results were inconsistent and did not permit broad co
