Importance of clinical decision support system response time monitoring: a case report

Abstract

Clinical decision support (CDS) systems are prevalent in electronic health records and drive many safety advantages. However, CDS systems can also cause unintended consequences. Monitoring programs focused on alert firing rates are important to detect anomalies and ensure systems are working as intended. Monitoring efforts do not generally include system load and time to generate decision support, which is becoming increasingly important as more CDS systems rely on external, web-based content and algorithms. We report a case in which a web-based service caused significant increase in the time to generate decision support, in turn leading to marked delays in electronic health record system responsiveness, which could have led to patient safety events. Given this, it is critical to consider adding decision support-time generation to ongoing CDS system monitoring programs.

A web-based fuzzy risk predictive-decision model of de novo stress urinary incontinence in women undergoing pelvic organ prolapse surgery

“…Accordingly, medical DSSs promise a significant advantage in improving the quality of medical decisions in order to better predict clinical outcomes. [ 10 , 11 ] These systems were first applied to the field of medicine in 1985 to increase the quality and efficiency of healthcare services and to reduce medical errors. [ 10 ] Subsequently, DSSs have been shown to significantly improve clinical performance.…”

“…Of relevance, Decision Support Systems (DSSs) have been introduced as computer-based tools that can help physicians make evidence-based treatment decisions and evaluate outcomes. Accordingly, medical DSSs promise a significant advantage in improving the quality of medical decisions in order to better predict clinical outcomes [10,11] . These systems were first applied to the field of medicine in 1985 to increase the quality and efficiency of healthcare services and to reduce medical errors [10] .…”