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Cdss cpoe

Matthew Rubinstein, Robert Hirsch, Kakali Bandyopadhyay, Bereneice Madison, Thomas Taylor, Anne Ranne, Millie Linville, Keri Donaldson, Felicitas Lacbawan, Nancy Cornish
Objectives: To evaluate the effectiveness of practices used to support appropriate clinical laboratory test utilization. Methods: This review followed the Centers for Disease Control and Prevention (CDC) Laboratory Medicine Best Practices A6 cycle method. Eligible studies assessed one of the following practices for effect on outcomes relating to over- or underutilization: computerized provider order entry (CPOE), clinical decision support systems/tools (CDSS/CDST), education, feedback, test review, reflex testing, laboratory test utilization (LTU) teams, and any combination of these practices...
February 17, 2018: American Journal of Clinical Pathology
Nicolas Delvaux, An De Sutter, Stijn Van de Velde, Dirk Ramaekers, Steffen Fieuws, Bert Aertgeerts
BACKGROUND: Laboratory testing is an important clinical act with a valuable role in screening, diagnosis, management and monitoring of diseases or therapies. However, inappropriate laboratory test ordering is frequent, burdening health care spending and negatively influencing quality of care. Inappropriate tests may also result in false-positive results and potentially cause excessive downstream activities. Clinical decision support systems (CDSSs) have shown promising results to influence the test-ordering behaviour of physicians and to improve appropriateness...
December 6, 2017: Implementation Science: IS
Justin Keasberry, Ian A Scott, Clair Sullivan, Andrew Staib, Richard Ashby
Objective The aim of the present study was to determine the effects of hospital-based eHealth technologies on quality, safety and efficiency of care and clinical outcomes. Methods Systematic reviews and reviews of systematic reviews of eHealth technologies published in PubMed/Medline/Cochrane Library between January 2010 and October 2015 were evaluated. Reviews of implementation issues, non-hospital settings or remote care or patient-focused technologies were excluded from analysis. Methodological quality was assessed using a validated appraisal tool...
December 2017: Australian Health Review: a Publication of the Australian Hospital Association
V Koutkias, J Bouaud
OBJECTIVE: To summarize recent research and select the best papers published in 2015 in the field of computerized clinical decision support for the Decision Support section of the IMIA yearbook. METHOD: A literature review was performed by searching two bibliographic databases for papers related to clinical decision support systems (CDSSs) and computerized provider order entry (CPOE) systems. The aim was to identify a list of candidate best papers from the retrieved papers that were then peer-reviewed by external reviewers...
November 10, 2016: Yearbook of Medical Informatics
Lucas M Okumura, Izelandia Veroneze, Celia I Burgardt, Marta F Fragoso
BACKGROUND: Computerized Provider Order Entry (CPOE) and Clinical Decision Support System (CDSS) help practitioners to choose evidence-based decisions, regarding patients' needs. Despite its use in developed countries, in Brazil, the impact of a CPOE/CDSS to improve cefazolin use in surgical prophylaxis was not assessed yet. OBJECTIVE: We aimed to evaluate the impact of a CDSS to improve the use of prophylactic cefazolin and to assess the cost savings associated to inappropriate prescribing...
July 2016: Pharmacy Practice
Erin A Vogel, Sarah J Billups, Sheryl J Herner, Thomas Delate
OBJECTIVE: The purpose of this study was to compare the effectiveness of an outpatient renal dose adjustment alert via a computerized provider order entry (CPOE) clinical decision support system (CDSS) versus a CDSS with alerts made to dispensing pharmacists. METHODS: This was a retrospective analysis of patients with renal impairment and 30 medications that are contraindicated or require dose-adjustment in such patients. The primary outcome was the rate of renal dosing errors for study medications that were dispensed between August and December 2013, when a pharmacist-based CDSS was in place, versus August through December 2014, when a prescriber-based CDSS was in place...
July 27, 2016: Applied Clinical Informatics
Ning Zhang, Susan F Lu, Biao Xu, Bingxiao Wu, Rosa Rodriguez-Monguio, Jerry Gurwitz
PURPOSE: Long-term care facilities have lagged heavily behind other health providers in adopting health information technology (IT). This article examines the facility characteristics that are associated with health IT adoption. DESIGN AND METHODS: This study is a secondary data analysis of information gathered between 2005 and 2011 about nursing facility characteristics contained in the Online Certification & Reporting (OSCAR) files and information about health IT adoption in each nursing home contained in the Healthcare Information and Management Systems Society (HIMSS) Analytics Database...
May 1, 2016: Journal of the American Medical Directors Association
Ali Reza Salili, Felix Hammann, Anne B Taegtmeyer
Adverse drug events pose a great risk to patients, are an everyday clinical problem and can have potential/ega/ consequences. Computerized physician order entry or computerized provider order entry (CPOE} in combination with clinical decision support systems {CDSS) are popular and aim to reduce prescribing errors as well as identifying potentially harmful drug drug interactions. The quantifiable benejit these systems bring to patients, has however, yet to be definitively proven. This article focusses on the current standpoint of CPOE-/CDSS, their risks and benefits, the potential for improvement and their perspectives for the future...
December 2015: Therapeutische Umschau. Revue Thérapeutique
V G Koutkias, P McNair, V Kilintzis, K Skovhus Andersen, J Niès, J-C Sarfati, E Ammenwerth, E Chazard, S Jensen, R Beuscart, N Maglaveras
BACKGROUND: Errors related to medication seriously affect patient safety and the quality of healthcare. It has been widely argued that various types of such errors may be prevented by introducing Clinical Decision Support Systems (CDSSs) at the point of care. OBJECTIVES: Although significant research has been conducted in the field, still medication safety is a crucial issue, while few research outcomes are mature enough to be considered for use in actual clinical settings...
2014: Methods of Information in Medicine
Nancy M Dunbar, Zbigniew M Szczepiorkowski
PURPOSE OF REVIEW: This review will describe recent applications of computerized provider order entry (CPOE) with clinical decision support systems (CDSS) in transfusion medicine and other novel ways information technology is being applied to support patient blood management (PBM) efforts. RECENT FINDINGS: CPOE with CDSS can be used to encourage appropriate transfusion practices as part of an institutional PBM program. The impact of CPOE with CDSS is enhanced when the laboratory information system (LIS) can be linked to the electronic medical record (EMR) to enable adaptive alerts that query transfusion orders against current laboratory and/or clinical data to ensure provider ordering practice is consistent with institutional guidelines...
November 2014: Current Opinion in Hematology
Yael Zenziper, Daniel Kurnik, Noa Markovits, Amitai Ziv, Ari Shamiss, Hillel Halkin, Ronen Loebstein
BACKGROUND: Prescription errors are common in hospitalized patients and result in significant morbidity, mortality and costs. Electronic prescriptions with computerized physician order entry systems (CPOE) and integrated computerized decision support systems (CDSS providing online alerts) reduce prescription errors by approximately 50%. However, the introduction of CDSS is often met by opposition due to the flood of alerts, and most prescribers eventually ignore even crucial alerts ("alert fatigue")...
May 2014: Israel Medical Association Journal: IMAJ
K M Vermeulen, J E van Doormaal, R J Zaal, P G M Mol, A W Lenderink, F M Haaijer-Ruskamp, J G W Kosterink, P M L A van den Bemt
INTRODUCTION: Prescribing medication is an important aspect of almost all in-hospital treatment regimes. Besides their obviously beneficial effects, medicines can also cause adverse drug events (ADE), which increase morbidity, mortality and health care costs. Partially, these ADEs arise from medication errors, e.g. at the prescribing stage. ADEs caused by medication errors are preventable ADEs. Until now, medication ordering was primarily a paper-based process and consequently, it was error prone...
August 2014: International Journal of Medical Informatics
Claudia Langebrake, Simone Melzer, Michael Baehr
The provision of drugs to hospitalised patients is a complex process with the involvement of different healthcare professionals. As pharmacotherapy is (1) one of the most common medical interventions, (2) a high-risk procedure, and (3) affects the majority of hospitalised patients, medication errors have sustainable impact on patient safety. Although medication errors can occur at different stages of drug use (prescribing, dispensing, administration), they are most likely within the prescribing process. According to the Reason's model of accident causation, these errors can be divided into active failures, error-provoking conditions, and latent conditions...
June 2014: Therapeutische Umschau. Revue Thérapeutique
Richard C Friedberg
No abstract text is available yet for this article.
2014: Journal of Pathology Informatics
Sumant R Ranji, Stephanie Rennke, Robert M Wachter
BACKGROUND: Adverse drug events (ADEs) are a major cause of morbidity in hospitalised and ambulatory patients. Computerised provider order entry (CPOE) combined with clinical decision support systems (CDSS) are being widely implemented with the goal of preventing ADEs, but the effectiveness of these systems remains unclear. METHODS: We searched the specialised database Agency for Healthcare Research and Quality (AHRQ) Patient Safety Net to identify reviews of the effect of CPOE combined with CDSS on ADE rates in inpatient and outpatient settings...
September 2014: BMJ Quality & Safety
Lotfi Bouzguenda, Manel Turki
This paper shows how the combined use of agent and web services technologies can help to design an architectural style for dynamic medical Cross-Organizational Workflow (COW) management system. Medical COW aims at supporting the collaboration between several autonomous and possibly heterogeneous medical processes, distributed over different organizations (Hospitals, Clinic or laboratories). Dynamic medical COW refers to occasional cooperation between these health organizations, free of structural constraints, where the medical partners involved and their number are not pre-defined...
April 2014: Journal of Medical Systems
Ryan A Collins, Darrell J Triulzi, Jonathan H Waters, Vivek Reddy, Mark H Yazer
OBJECTIVES: To evaluate cryoprecipitate and platelet ordering practices after the implementation of real-time clinical decision support systems (CDSSs) in a computerized physician order entry (CPOE) system. METHODS: Uniform platelet and cryoprecipitate transfusion thresholds were implemented at 11 hospitals in a regional health care system with a common CPOE system. Over 6 months, a variety of information was collected on the ordering physicians and the number of alerts generated by the CDSSs when these products were ordered outside of the institutional guidelines...
January 2014: American Journal of Clinical Pathology
Rianne J Zaal, Mark M P M Jansen, Marjolijn Duisenberg-van Essenberg, Cees C Tijssen, Jan A Roukema, Patricia M L A van den Bemt
BACKGROUND: Both clinical pharmacists and computerized physician order entry systems with clinical decision support (CPOE/CDSS) can reduce drug-related problems (DRPs). However, the contribution of a clinical pharmacist in addition to CPOE/CDSS has not been established in a prospective study. OBJECTIVE: To determine which DRPs can be identified by a clinical pharmacist in a setting with routine use of CPOE/CDSS. SETTING: Two surgical and two neurological wards in St...
October 2013: International Journal of Clinical Pharmacy
B Sheehan, D Kaufman, S Bakken, L M Currie
BACKGROUND: Clinical decision support systems (CDSS) are a method used to support prescribing accuracy when deployed within a computerized provider order entry system (CPOE). Divergence from using CDSS is exemplified by high alert override rates. Excessive cognitive load imposed by the CDSS may help to explain such high rates. OBJECTIVES: The aim of this study was to describe the cognitive impact of a CPOE-integrated CDSS by categorizing system use problems according to the type of mental processing required to resolve them...
2012: Applied Clinical Informatics
Michael Stabile, Lebron Cooper
PURPOSE: The adoption of new technologies in medicine is frequently met with both enthusiasm and resistance. The universal adoption of health information technology (IT) and anesthesia information management systems (AIMS) remains low despite the potential benefits. Electronic medical records, and hence AIMS, are at the intersection of patient safety. This article highlights advantages and barriers to adoption and implementation of IT in general and AIMS in particular, with a focus on clinical decision support systems (CDSS) and computerized physician order entry (CPOE) as hallmarks that may lead to improvement in patient safety and quality in the perioperative setting...
February 2013: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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