How to Develop and Implement a Computerized Decision Support System Integrated for Antimicrobial Stewardship?...

Area of Science:

• Health Informatics
• Clinical Decision Support
• Antimicrobial Stewardship

Background:

• Computerized decision support systems (CDSS) offer potential for automating antimicrobial stewardship (AMS) interventions within routine healthcare.
• Despite international guideline recommendations, the implementation of CDSS for AMS remains limited.
• The COMPuterized Antibiotic Stewardship Study (COMPASS) developed and integrated two CDSSs into electronic health records at two Swiss public hospitals.

Purpose of the Study:

• To describe key lessons learned from developing and implementing CDSS for AMS in a real-world hospital setting.
• To provide practical recommendations for future CDSS development and implementation projects.
• To highlight challenges encountered and strategies for overcoming them.

Main Methods:

• Narrative review of experiences from the COMPASS study.
• Development and implementation of two CDSSs for antimicrobial prescriptions.
• Integration of CDSS into existing electronic health records.

Main Results:

• Challenges were encountered throughout the development and implementation phases.
• Key lessons learned span from initial planning and design to implementation and assessment.
• Recommendations are provided for optimizing CDSS functionality, usability, and integration.

Conclusions:

• Successful CDSS implementation for AMS requires a multidisciplinary approach, transparent design, and user engagement.
• Early usability testing, comprehensive training, and proactive planning for maintenance are crucial.
• Addressing financial and adaptation challenges is essential for long-term sustainability of CDSS in healthcare.