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AMIA Annu Symp Proc. 2007 Oct 11:26-30.

Some unintended consequences of clinical decision support systems.

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  • 1Department of Medical Informatics and Clinical Epidemiology, School of Medicine, Oregon Health & Science University, Portland, OR, USA.

Abstract

Clinical decision support systems (CDS) coupled with computerized physician/provider order entry (CPOE) can improve the quality of patient care and the efficiency of hospital operations. However, they can also produce unintended consequences. Using qualitative methods, a multidisciplinary team gathered and analyzed data about the unintended consequences of CPOE, identifying nine types, and found that CDS-generated unintended consequences appeared among all types. Further analysis of 47 CDS examples uncovered three themes related to CDS content: elimination or shifting of human roles; difficulty in keeping content current; and inappropriate content. Three additional themes related to CDS presentation were found: rigidity of the system; alert fatigue; and potential for errors. Management of CDS must include careful selection and maintenance of content and prudent decision making about human computer interaction opportunities.

PMID:
18693791
[PubMed - indexed for MEDLINE]
PMCID:
PMC2813668
Free PMC Article
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