Computerized decision support in adult and pediatric critical care

Abstract

Computerized decision support (CDS) is the most advanced form of clinical decision support available and has evolved with innovative technologies to provide meaningful assistance to medical professionals. Critical care clinicians are in unique environments where vast amounts of data are collected on individual patients, and where expedient and accurate decisions are paramount to the delivery of quality healthcare. Many CDS tools are in use today among adult and pediatric intensive care units as diagnostic aides, safety alerts, computerized protocols, and automated recommendations for management. Some CDS use have significantly decreased adverse events and improved costs when carefully implemented and properly operated. CDS tools integrated into electronic health records are also valuable to researchers providing rapid identification of eligible patients, streamlining data-gathering and analysis, and providing cohorts for study of rare and chronic diseases through data-warehousing. Although the need for human judgment in the daily care of critically ill patients has limited the study and realization of meaningful improvements in overall patient outcomes, CDS tools continue to evolve and integrate into the daily workflow of clinicians, and will likely provide advancements over time. Through novel technologies, CDS tools have vast potential for progression and will significantly impact the field of critical care and clinical research in the future.

Keywords: Clinical decision support systems; Critical care; Computers; Computer-assisted decision making

Core tip: Computerized decision support (CDS) is increasingly utilized in both adult and pediatric critical care. Improvements in care have been shown in areas including guideline adherence and reduction of medical errors, but reports of meaningful improvements in patient outcome have been scarce to date. However, with technology improvements and widespread acceptance of tools, CDS has the potential to revolutionize critical care medicine with improved diagnosis, monitoring, risk prediction, and treatment. Improvements in multiple aspects of patient care through CDS tools can lead to better patient outcomes.