The Value of Monitoring Clinical Decision Support Interventions

Area of Science:

• Health Informatics
• Clinical Decision Support Systems
• Healthcare Quality Improvement

Background:

• Well-functioning clinical decision support (CDS) systems improve workflow, patient care, outcomes, and reduce costs.
• Poorly functioning CDS can lead to alert fatigue, decreased provider satisfaction, and ignored interventions.

Purpose of the Study:

• To describe an institutional program for creating and maintaining effective CDS.
• Focus on systematic monitoring of CDS firing rates and patterns.

Main Methods:

• Implemented four types of CDS monitoring activities throughout the CDS lifecycle.
• Monitoring included preactivation and postactivation phases.
• Utilized an automated alert detection tool and expert evaluation for optimization.

Main Results:

• Detected malfunctions or improvement opportunities in 37% of interventions preactivation and 18% postactivation.
• Automated tool identified 128 alert pattern changes over two years.
• Monitoring informed user feedback response and tool optimization.

Conclusions:

• CDS monitoring is crucial for identifying issues post-implementation.
• Continuous, automated monitoring detects real-time malfunctions.
• CDS monitoring should be integral to CDS implementation and maintenance programs.