Intraoperative Clinical Decision Support for Anesthesia: A Narrative Review of Available Systems

Area of Science:

• Anesthesiology
• Medical Informatics
• Clinical Decision Support Systems

Background:

• Anesthesia Information Management Systems (AIMS) are increasingly adopted.
• There is growing interest in leveraging AIMS data for intraoperative clinical decision support (CDS).
• CDS in anesthesia can enhance care quality, patient safety, billing, and compliance.

Purpose of the Study:

• To review different types of intraoperative CDS systems, focusing on real-time applications.
• To systematically cover technical considerations for developing and implementing real-time CDS.
• To discuss regulatory aspects and effectiveness assessment of intraoperative CDS.

Main Methods:

• Systematic review of intraoperative CDS systems.
• Description of functional modules, decision rule development, and alerting modalities for CDS.
• Analysis of regulatory considerations and methods for effectiveness assessment.

Main Results:

• Intraoperative CDS ranges from passive to active real-time systems.
• Real-time CDS provides alerts and guidance to promote evidence-based care during surgery.
• Technical and regulatory factors are crucial for CDS development and implementation.

Conclusions:

• Real-time intraoperative CDS holds significant potential for improving anesthesia care.
• Future development may include predictive and prescriptive decision support capabilities.
• Effective implementation requires addressing technical, regulatory, and assessment challenges.