The Use of Computer Decision Support Systems for the Critical Care Environment

Abstract

Abstract : As the workload of primary care providers continues to increase, the use of automation in the intensive care unit (ICU) environment has been touted as a way to increase effectiveness of patient care and standardize practice, while reducing the number of complications associated with the use of manually implemented approaches.1 4 Medical computer decision support (CDS), or computer decision assist, applications are a type of information technology system that embed the expertise of experienced care providers and/or standards of care into a computerized system. They can be implemented at any care level including prehospital, emergency departments, operating rooms, and ICUs. These systems provide information on patient care issues as an adjunct to standard treatments used during the patient s stay. For example, a typical CDS system may provide alerts when a combination of patient parameters fall out of range and recommend changes in drug rates to the care provider to bring the patient parameters within acceptable limits. By providing clinicians with these types of applications, patient care is improved in 2 ways. First, they provide a tool for learning and quality improvement. These systems provide the ability to push the expertise of more experienced care providers to clinicians who may not be fully trained or may be unfamiliar with current evidence based practice (EBP) guidelines. Second, as a decision support adjunct, these systems provide additional information that may not be otherwise available or easily obtainable to experienced care providers. Computer decision support systems improve the provider s ability to manage multiple sources of data, allow for trending analysis, and provide the ability to fuse data from multiple sources. Furthermore, these tools allow for advanced information processing that can be used in predictive modeling of patient outcomes.