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Evaluating the alert appropriateness of clinical decision support systems in supporting clinical workflow.
Journal of Biomedical informatics ( IF 4.0 ) Pub Date : 2020-05-14 , DOI: 10.1016/j.jbi.2020.103453 Olufisayo Olusegun Olakotan 1 , Maryati Mohd Yusof 1
Journal of Biomedical informatics ( IF 4.0 ) Pub Date : 2020-05-14 , DOI: 10.1016/j.jbi.2020.103453 Olufisayo Olusegun Olakotan 1 , Maryati Mohd Yusof 1
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The overwhelming number of medication alerts generated by clinical decision support systems (CDSS) has led to inappropriate alert overrides, which may lead to unintended patient harm. This review highlights the factors affecting the alert appropriateness of CDSS and barriers to the fit of CDSS alert with clinical workflow. A literature review was conducted to identify features and functions pertinent to CDSS alert appropriateness using the five rights of CDSS. Moreover, a process improvement method, namely, Lean, was used as a tool to optimise clinical workflows, and the appropriate design for CDSS alert using a human automation interaction (HAI) model was recommended. Evaluating the appropriateness of CDSS alert and its impact on workflow provided insights into how alerts can be designed and triggered effectively to support clinical workflow. The application of Lean methods and tools to analyse alert efficiencies in supporting workflow in this study provides an in-depth understanding of alert-workflow fit problems and their root cause, which is required for improving CDSS design. The application of the HAI model is recommended in the design of CDSS alerts to support various levels and stages of alert automations, namely, information acquisition and analysis, decision action and action implementation.
中文翻译：
在支持临床工作流程中评估临床决策支持系统的警报适当性。
由临床决策支持系统（CDSS）生成的大量药物警报导致了不适当的警报超控，这可能导致意外的患者伤害。这篇综述重点介绍了影响CDSS警报适用性的因素以及CDSS警报与临床工作流程相适应的障碍。进行了文献综述，以使用CDSS的五项权利来确定与CDSS警报适当性有关的特征和功能。此外，将过程改进方法（即精益）用作优化临床工作流程的工具，并建议使用人工自动化交互（HAI）模型对CDSS警报进行适当的设计。评估CDSS警报的适当性及其对工作流程的影响提供了有关如何设计和有效触发警报以支持临床工作流程的见解。本研究中应用精益方法和工具来分析警报效率以支持工作流程的过程，可以深入了解警报工作流程适合性问题及其根本原因，这是改进CDSS设计所必需的。在CDSS警报的设计中建议使用HAI模型，以支持警报自动化的各个级别和阶段，即信息获取和分析，决策行动和行动实施。
更新日期：2020-05-14
中文翻译：
在支持临床工作流程中评估临床决策支持系统的警报适当性。
由临床决策支持系统（CDSS）生成的大量药物警报导致了不适当的警报超控，这可能导致意外的患者伤害。这篇综述重点介绍了影响CDSS警报适用性的因素以及CDSS警报与临床工作流程相适应的障碍。进行了文献综述，以使用CDSS的五项权利来确定与CDSS警报适当性有关的特征和功能。此外，将过程改进方法（即精益）用作优化临床工作流程的工具，并建议使用人工自动化交互（HAI）模型对CDSS警报进行适当的设计。评估CDSS警报的适当性及其对工作流程的影响提供了有关如何设计和有效触发警报以支持临床工作流程的见解。本研究中应用精益方法和工具来分析警报效率以支持工作流程的过程，可以深入了解警报工作流程适合性问题及其根本原因，这是改进CDSS设计所必需的。在CDSS警报的设计中建议使用HAI模型，以支持警报自动化的各个级别和阶段，即信息获取和分析，决策行动和行动实施。
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