Importance of clinical decision support system response time monitoring: a case report.
Importance of clinical decision support system response time monitoring: a case report.
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临床决策支持系统响应时间监控的重要性：案例报告。
DOI：
10.1093/jamia/ocz133
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Landman,Adam
中科院分区：
文献类型：
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作者：
Rubins,David;Wright,Adam;Alkasab,Tarik;Ledbetter,MStephen;Miller,Amy;Patel,Rajesh;Wei,Nancy;Zuccotti,Gianna;Landman,Adam
临床决策支持（CDS）系统在电子健康记录中很普遍，并具有许多安全优势。然而，CDS系统也可能导致意想不到的后果。监控程序专注于警报发射率，对于检测异常并确保系统按预期工作非常重要。监测工作通常不包括系统负载和生成决策支持的时间，这一点变得越来越重要，因为越来越多的CDS系统依赖于外部的、基于网络的内容和算法。我们报告的情况下，基于Web的服务导致显着增加的时间来生成决策支持，从而导致显着延迟电子健康记录系统的响应，这可能会导致患者的安全事件。鉴于此，考虑将决策支持时间生成添加到正在进行的CDS系统监控程序中至关重要。
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.