Ten Commandments for Effective Decision Support in Physical Therapy

1. Speed is Everything
2. Anticipate the Physical Therapist's Need and Deliver Them In Real Time 
3. Fit the Technology into the Physical Therapist's Workflow
4. Little Things Make a Big Difference
5. Recognize that Physical Therapists will Strongly Resist Stopping the Treatment
6. Changing Directions is Easier Than Stopping
7. Simple Interventions Work Best
8. Ask For Additional Information from the Physical Therapist ONLY When You Need It
9. Monitor Impact, Get Feedback and Respond
10. Manage and Maintain Clinical Decision Support Systems for Physical Therapists

These commandments were originally written by Dr. David Bates in 2003 in anticipation of the electronic medical records revolution physical therapists and physicians are witnessing now.

They are surely as true now as they were then.

I would humbly suggest one additional commandment to add, in light of the recent, massive failure of the British centralized database of electronic medical records:

11. Empower LOCAL decision makers (eg: physical therapists) to add to, delete or modify the decision support rules and allow interoperable CDS systems to "learn" from each other.

Right now, the ONLY CDS system that applies to physical therapists is a top-down government-mandated program that is, for the most part, paper-based.

I think we can do better.

What do you think?

Please comment.