Clinical decision support systems
Clinical decision support (CDS) systems link patient data with an electronic knowledge base in order to improve decision-making and computerised physician order entry (CPOE) is a requirement to set up electronic CDS. The medical informatics literature suggests categorising CDS tools into medicatio...
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2014-12-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/1954 |
| _version_ | 1797979581518446592 |
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| author | Patrick Emanuel Beeler David Westfall Bates Balthasar L Hug |
| author_facet | Patrick Emanuel Beeler David Westfall Bates Balthasar L Hug |
| author_sort | Patrick Emanuel Beeler |
| collection | DOAJ |
| description |
Clinical decision support (CDS) systems link patient data with an electronic knowledge base in order to improve decision-making and computerised physician order entry (CPOE) is a requirement to set up electronic CDS. The medical informatics literature suggests categorising CDS tools into medication dosing support, order facilitators, point-of-care alerts and reminders, relevant information display, expert systems and workflow support. To date, CDS has particularly been recognised for improving processes. CDS successfully fostered prevention of deep-vein thrombosis, improved adherence to guidelines, increased the use of vaccinations, and decreased the rate of serious medication errors. However, CDS may introduce errors, and therefore the term “e-iatrogenesis” has been proposed to address unintended consequences. At least two studies reported severe treatment delays due to CPOE and CDS. In addition, the phenomenon of “alert fatigue” – arising from a high number of CDS alerts of low clinical significance – may facilitate overriding of potentially critical notifications. The implementation of CDS needs to be carefully planned, CDS interventions should be thoroughly examined in pilot wards only, and then stepwise introduced. A crucial feature of CPOE in combination with CDS is speed, since time consumption has been found to be a major factor determining failure. In the near future, the specificity of alerts will be improved, notifications will be prioritised and offer detailed advice, customisation of CDS will play an increasing role, and finally, CDS is heading for patient-centred decision support. The most important research question remains whether CDS is able to improve patient outcomes beyond processes.
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| first_indexed | 2024-04-11T05:42:09Z |
| format | Article |
| id | doaj.art-1d9679cec5d9498ebd05f0c339afb9d8 |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-11T05:42:09Z |
| publishDate | 2014-12-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-1d9679cec5d9498ebd05f0c339afb9d82022-12-22T04:42:31ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972014-12-01144515210.4414/smw.2014.14073Clinical decision support systemsPatrick Emanuel BeelerDavid Westfall BatesBalthasar L Hug Clinical decision support (CDS) systems link patient data with an electronic knowledge base in order to improve decision-making and computerised physician order entry (CPOE) is a requirement to set up electronic CDS. The medical informatics literature suggests categorising CDS tools into medication dosing support, order facilitators, point-of-care alerts and reminders, relevant information display, expert systems and workflow support. To date, CDS has particularly been recognised for improving processes. CDS successfully fostered prevention of deep-vein thrombosis, improved adherence to guidelines, increased the use of vaccinations, and decreased the rate of serious medication errors. However, CDS may introduce errors, and therefore the term “e-iatrogenesis” has been proposed to address unintended consequences. At least two studies reported severe treatment delays due to CPOE and CDS. In addition, the phenomenon of “alert fatigue” – arising from a high number of CDS alerts of low clinical significance – may facilitate overriding of potentially critical notifications. The implementation of CDS needs to be carefully planned, CDS interventions should be thoroughly examined in pilot wards only, and then stepwise introduced. A crucial feature of CPOE in combination with CDS is speed, since time consumption has been found to be a major factor determining failure. In the near future, the specificity of alerts will be improved, notifications will be prioritised and offer detailed advice, customisation of CDS will play an increasing role, and finally, CDS is heading for patient-centred decision support. The most important research question remains whether CDS is able to improve patient outcomes beyond processes. https://www.smw.ch/index.php/smw/article/view/1954medicinehealth ITDecision support systems |
| spellingShingle | Patrick Emanuel Beeler David Westfall Bates Balthasar L Hug Clinical decision support systems Swiss Medical Weekly medicine health IT Decision support systems |
| title | Clinical decision support systems |
| title_full | Clinical decision support systems |
| title_fullStr | Clinical decision support systems |
| title_full_unstemmed | Clinical decision support systems |
| title_short | Clinical decision support systems |
| title_sort | clinical decision support systems |
| topic | medicine health IT Decision support systems |
| url | https://www.smw.ch/index.php/smw/article/view/1954 |
| work_keys_str_mv | AT patrickemanuelbeeler clinicaldecisionsupportsystems AT davidwestfallbates clinicaldecisionsupportsystems AT balthasarlhug clinicaldecisionsupportsystems |