Effect of Clinical Decision-Support Systems

Bright, Tiffani J; Wong, Anthony; Ravi, Dhurjati; Bristow, Erin; Bastian, Lori A.; Coeytaux, Remy R; Samsa, Gregory P.; Hasselblad, Vic; Williams, John W; Musty, Michael; Wing, Liz; Kendrick, Amy; Sanders, Gillian D; Lobach, David F.

doi:10.7326/0003-4819-157-1-201207030-00450

Cited by 930 publications

(688 citation statements)

References 147 publications

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“…Existing evidence evaluating the effect of introducing HIT systems such as Computerized Physician Order Entry (CPOE) highlight how unintended consequences can occur once such systems are introduced [13][14][15][16][17][18], and the evidence base supporting the effectiveness of CDSS to improve patient outcomes is equivocal [19]. Similarly, the literature on the effects of using quality measures to improve performance at an organizational level highlights the problems that dashboards can introduce, such as incentivizing certain behaviors or outcomes at the expense of others.…”

Section: Introductionmentioning

confidence: 99%

Dashboards for improving patient care: Review of the literature

Dowding¹,

Randell²,

Gardner³

et al. 2015

International Journal of Medical Informatics

261

273

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Aim: This review aimed to provide a comprehensive overview of the current state of evidence for the use of clinical and quality dashboards in health care environments. Methods:A literature search was performed for the dates 1996 to 2012 on CINAHL, Medline, Embase, Cochrane Library, PsychInfo, Science Direct and ACM Digital Library. A citation search and a hand search of relevant papers were also conducted.Results: One hundred and twenty two full text papers were retrieved of which 11 were included in the review. There was considerable heterogeneity in implementation setting, dashboard users and indicators used. There was evidence that in contexts where dashboards were easily accessible to clinicians (such as in the form of a screen saver) their use was associated with improved care processes and patient outcomes. Conclusion:There is some evidence that implementing clinical and/or quality dashboards that provide immediate access to information for clinicians can improve adherence to quality guidelines and may help improve patient outcomes. However, further high quality detailed research studies need to be conducted to obtain evidence of their efficacy and establish guidelines for their design.4

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Section: Introductionmentioning

confidence: 99%

Dashboards for improving patient care: Review of the literature

Dowding¹,

Randell²,

Gardner³

et al. 2015

International Journal of Medical Informatics

261

273

View full text Add to dashboard Cite

show abstract

“…The first selected paper perfectly fits the topic of this year's Yearbook, evidence-based health informatics: a systematic review by Bright et al [3] on the effects of CDSSs in real settings considering different types of outcomes. It confirms that CDSSs can improve healthcare process measures and that evidence lacks to show a significant effect on other types of outcomes (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the wide variety of CDSSs and of interventions observed in published studies limits the conclusions of systematic reviews. A standardization in the characterization of the systems and of CDSS-based intervention trial reporting, as some authors [3,17] call for, will certainly be necessary to better understand and evaluate the effects of CDSSs in the future. Assessing the effective impact of clinical decision support systems (CDSSs) is still a major concern.…”

Section: Discussionmentioning

confidence: 99%

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A Medical Informatics Perspective on Clinical Decision Support Systems

Bouaud

2013

Yearb Med Inform

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SummaryObjective: To summarize excellent research and to select best papers published in 2012 in the field of computer-based decision support in healthcare. Methods: A bibliographic search focused on clinical decision support systems (CDSSs) and computer provider order entry was performed, followed by a double-blind literature review. Results: The review process yielded six papers, illustrating various aspects of clinical decision support. The first paper is a systematic review of CDSS intervention trials in real settings, and considers different types of possible outcomes. It emphasizes the heterogeneity of studies and confirms that CDSSs can improve process measures but that evidence lacks for other types of outcomes, especially clinical or economic. Four other papers tackle the safety of drug prescribing and show that CDSSs can be efficient in reducing prescription errors. The sixth paper exemplifies the growing role of ontological resources which can be used for several applications including decision support. Conclusions: CDSS research has to be continuously developed and assessed. The wide variety of systems and of interventions limits the understanding of factors of success of CDSS implementations. A standardization in the characterization of CDSSs and of intervention trial reporting will help to overcome this obstacle.

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“…The implementation of Health Information Technology (HIT) is the key element for reducing the error in system change. There are two common HIT systems used in hospital, namely Computerized Physician Order Entry and Clinical Decision Support Systems, and various evaluation studies found that these two HIT systems had significantly reduced the medical errors (Maslove, Rizk, & Lowe, 2011;Jaspers, Smeulers, Vermeulen, &Peute, 2011;Bright et al, 2012). In addition, OBA also suggests that advanced education and training decrease the errors caused by active failure (Cunningham & Geller, 2009), thus the health practitioners may improve their knowledge and skill (Pani&Chariker, 2004).…”

Section: Medical Errormentioning

confidence: 99%

Patient Safety Issues: The Role of Organizational Behavioral Approach (Oba) in Addressing Issues Related to Medical Error and Safety Culture

Fatmawati

Taufik

2017

PJP

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During these recent years, patient safety has become a prominent issue in the medical atmosphere and appeared to be the main target for improvement (Leroy et al., 2012). As one of the disciplines in health sciences, psychology might play an important role in addressing the problems occurred in patient safety. There are broad aspects where psychology may contribute (Nash, McKay, Vogel, & Masters, 2012), but the involvement of psychology in changing the safety within health care setting has been underestimated and its role has been partially described (Øvretveit, 2009).Therefore, this paper is proposed in order to demonstrate one of the behavioral theories in psychology, named the Organizational Behavioral Approach (OBA) to give a wider understanding on how psychologist may contribute to address the issues in patient safety, especially the problems related to medical error and safety culture.

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Effect of Clinical Decision-Support Systems

Abstract: Agency for Healthcare Research and Quality.

Cited by 930 publications

References 147 publications

Dashboards for improving patient care: Review of the literature

Dashboards for improving patient care: Review of the literature

A Medical Informatics Perspective on Clinical Decision Support Systems

Patient Safety Issues: The Role of Organizational Behavioral Approach (Oba) in Addressing Issues Related to Medical Error and Safety Culture

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