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Interprofessional Evaluation of a Medication Clinical Decision Support System Prior to Implementation
Jacqueline Bauer1, Marika Busse1, Tanja Kopetzky2
1Pharmacy Department, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Applied Clinical Informatics
|July 31, 2024
Summary
Evaluating clinical decision support systems (CDSS) is vital for optimizing medication safety. Interprofessional evaluation before implementation helps identify limitations and improve system use in hospitals.
Area of Science:
- Health Informatics
- Clinical Pharmacy
- Patient Safety
Background:
- Digitalization in hospitals has led to widespread use of Computerized Physician Order Entry (CPOE) and Clinical Decision Support Systems (CDSS).
- While CPOE and CDSS can reduce medication errors and enhance patient safety, they also present risks like overalerting and nonadoption.
- Optimizing CDSS functionality requires careful evaluation of their components, such as Medication-Safety-Validators.
Purpose of the Study:
- To evaluate a specific CDSS (Meona) with Medication-Safety-Validators to identify limitations for optimizing clinical routine use.
- To assess the impact of local activation/deactivation choices on CDSS effectiveness.
- To compare configurations across multiple institutions.
Main Methods:
- An interprofessional evaluation of Meona CDSS and its Medication-Safety-Validators was conducted at a German University hospital.
- A systematic validation process included general evaluation, technical/content review, and decisions on activation/deactivation modes (interruptive vs. passive).
- A survey of 12 German University hospitals using Meona compared their system configurations.
Main Results:
- 3 out of 10 evaluated Medication-Safety-Validators were deactivated due to limitations.
- Of the seven activated validators, four used an interruptive mode and three used an on-demand mode.
- Significant variations in site-specific configurations and medication safety alerts were observed across participating hospitals.
Conclusions:
- Interprofessional evaluation of CPOE and CDSS before clinical implementation is essential for identifying limitations.
- Such evaluations support sustainable system utilization and have the potential to improve medication safety.
- Tailored configuration of CDSS components is critical for effective clinical use.
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