Computerized decision support systems: an overview

Abstract

Computerized clinical decision support systems (CDSS) are an area of technology that attract much interest. In the past, the prohibitive cost of the high performance systems needed to run such systems effectively confined their use to large research and teaching units. The decreasing price and increasing power of personal computers is making their widespread use more possible. CDSS are divided into active and passive systems. Passive systems make information available should the clinician specifically request it, whereas active systems process information and interact with clinical data. Active CDSS may use rules based upon simple logic or systems based upon probability. A variety of active CDSS systems have been shown to have a positive effect on patient outcome. Such an effect has yet to be clearly demonstrated for passive CDSS. CDSS should be carefully designed, so that they are accurate, safe, useful and accessible to the clinician. In this way, their utility can be maximized. Medical knowledge is expanding rapidly, and it is unlikely that the clinician of the future will know even a small proportion of it. It is thus important that information is available in a digestible form and in close proximity to the clinical context. CDSS are likely to be one of the major ways to deliver such data.