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Connecting the dots: rule-based decision support systems in the modern EMR era
Vitaly Herasevich1, Daryl J Kor, Arun Subramanian
1Division of Critical Care Medicine, Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA. Herasevich.vitaly@mayo.edu
Journal of Clinical Monitoring and Computing
|March 5, 2013
Summary
Smart alarms and decision support systems (DSS) in intensive care units (ICUs) can improve patient safety. Novel informatics methods may enhance next-generation DSS to overcome current alert fatigue and improve early recognition of patient issues.
Area of Science:
- Medical Informatics
- Critical Care Medicine
Background:
- Intensive care units (ICUs) generate vast amounts of medical device and electronic medical record (EMR) data.
- Critically ill patients are susceptible to medical errors and delayed interventions, leading to increased morbidity, mortality, and costs.
- Current smart alarms and decision support systems (DSS) in ICUs often generate false alerts, contributing to alert fatigue and failing to support early recognition of complex conditions.
Purpose of the Study:
- To explore the potential of novel medical informatics methods for developing next-generation, rule-based DSS in the ICU.
- To address the limitations of current ICU alert systems, including false alerts and alert fatigue.
- To improve patient safety and outcomes through enhanced clinical decision support.
Main Methods:
- Review of existing literature on ICU data, clinical decision support systems, and medical informatics.
- Conceptualization of next-generation DSS adaptable to widespread EMR implementation.
- Focus on rule-based systems for early recognition of complex physiologic syndromes and deviations from care pathways.
Main Results:
- Current ICU alert systems are suboptimal, with prevalent false alerts and alert fatigue.
- The rich data environment in ICUs offers opportunities for advanced informatics applications.
- Next-generation DSS hold promise for improving clinician support in recognizing critical patient conditions.
Conclusions:
- Novel medical informatics methods can be adapted to create advanced, rule-based DSS for ICUs.
- Improved DSS have the potential to enhance patient safety and outcomes in critical care settings.
- Addressing alert fatigue and enhancing early recognition are key goals for future ICU clinical information systems.
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