Key result
Perioperative CDS systems can optimize care quality despite fundamental latency and data reliability challenges.
Why the study?
Clinical decision support systems are increasingly important for optimizing perioperative care in cardiac, thoracic, and vascular procedures, but effective integration with perioperative information management systems requires understanding workflow and technical challenges.
Clinical decision support systems integrated into perioperative information management systems can optimize care delivery during cardiac and vascular procedures, despite challenges with latency and data reliability.
May support integration of decision support into perioperative systems for cardiac procedures; leaves open validation of latency and reliability effects in prospective trials.
Clinical decision support (CDS) systems are being used to optimize the increasingly complex care that our health care system delivers. These systems have become increasingly important in the delivery of perioperative care for patients undergoing cardiac, thoracic, and vascular procedures. The adoption of perioperative information management systems (PIMS) has allowed these technologies to enter the operating room and support the clinical work flow of anesthesiologists and operational processes. Constructing effective CDS systems necessitates an understanding of operative work flow and technical considerations as well as achieving integration with existing information systems. In this review, we describe published examples of CDS for PIMS, including support for cardiopulmonary bypass separation physiological alarms, β-blocker guideline adherence, enhanced revenue capture for arterial line placement, and detection of hemodynamic monitoring gaps. Although these and other areas are amenable to CDS systems, the challenges of latency and data reliability represent fundamental limitations on the potential application of these tools to specific types of clinical issues. Ultimately, we expect that CDS will remain an important tool in our efforts to optimize the quality of care delivered.
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Wanderer et al. (2013) conducted a review in Perioperative care for patients undergoing cardiac, thoracic, and vascular procedures. Clinical decision support (CDS) for perioperative information management systems (PIMS) was evaluated. Clinical decision support systems integrated with perioperative information management systems can optimize care quality, though latency and data reliability remain fundamental challenges.
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