Informatics support for clinical decisions

Abstract

The utilization of Clinical Decision Support (CDS) systems is increasing with implementation of Electronic Health Record (EHR) systems across the USA. One of the first and most studied CDS applications has been computerized provider order entry (CPOE), particularly CPOE related to medications. Many EHR systems check drug dosage, allergies, and drug-drug interactions as clinicians enter their orders, and issue alerts as needed. However, alert overriding in CPOE systems is common practice. Nanji et al ( see page 487 ) reports that over 50% of alerts are overridden at a particular academic health center and proposes how to decrease unintended CPOE effects on workflows and communications ( see page 481 ). Related to workflows, Coiera ( see page 414 ) offers a model to study workspaces in which critical communications among clinicians occur. Many articles in this issue focus on medication management, including three systematic reviews that address barriers and facilitators …