Applied Clinical Informatics最新文献

{"title":"Coverage of physical therapy assessments in the Observational Medical Outcomes Partnership Model common data model.","authors":"Margaret A French, Paul Hartman, Heather A Hayes, Leah Ling, John Magel, Anne Thackeray","doi":"10.1055/a-2401-3688","DOIUrl":"https://doi.org/10.1055/a-2401-3688","url":null,"abstract":"<p><strong>Background: </strong>High-value care aims to enhance meaningful patient outcomes while reducing costs and is accelerated by curating data across healthcare systems through common data models (CDMs), such as Observational Medical Outcomes Partnership Model (OMOP). Meaningful patient outcomes, such as physical function, must be included in these CDMs. However, the extent that physical therapy assessments are covered in the OMOP CDM is unclear.</p><p><strong>Objective: </strong>Examine the extent that physical therapy assessments used in neurologic and orthopaedic conditions are in the OMOP CDM.</p><p><strong>Methods: </strong>After identifying assessments, two reviewer teams independently mapped the neurologic and orthopaedic assessments into the OMOP CDM. We quantified agreement within the reviewer team by the number of assessments mapped by both reviewers, one reviewer but not the other, or neither reviewer. The reviewer teams then reconciled disagreements, after which we examined agreement and the average number of concept ID numbers per assessment.</p><p><strong>Results: </strong>Of the 81 neurologic assessments, 48.1% (39/81) were initially mapped by both reviewers, 9.9% (8/81) were mapped by one reviewer but not the other, and 42% (34/81) were unmapped. After reconciliation, 46.9% (38/81) were mapped by both reviewers and 53.1% (43/81) were unmapped. Of the 79 orthopaedic assessments, 46.8% (37/79) were initially mapped by both reviewers, 12.7% (10/79) were mapped by one reviewer but not the other, and 48.1% (38/79) were unmapped. After reconciliation, 48.1% (38/79) were mapped by both reviewers and 51.9% (41/79) were unmapped. Most assessments that were mapped had more than one concept ID number (2.2±1.3 and 4.3±4.4 concept IDs per neurologic and orthopaedic assessment, respectively).</p><p><strong>Conclusions: </strong>The OMOP CDM includes some assessments recommended for use in neurologic and orthopaedic conditions, but many have multiple concept IDs. Including more functional assessments in the OMOP CDM and creating guidelines for mapping would improve our ability to include functional data in large datasets.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Special Issue on Informatics Education: Developing and Implementing a Clinical Informatics Fellowship Curriculum.","authors":"Lindsey Spiegelman, Scott Rudkin, Sonia Portillo, Ryan O'Connell","doi":"10.1055/a-2394-4611","DOIUrl":"https://doi.org/10.1055/a-2394-4611","url":null,"abstract":"<p><p>We developed and implemented a novel internal clinical informatics curriculum for the UCI Fellowship Program. We sought to innovate the program's educational approach by transitioning from an external to an internal curriculum in response to feedback and the evolving needs of the field. This case study outlines the rationale, design process, challenges, and outcomes of this curriculum development effort.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successfully transitioning an interruptive alert into a non-interruptive alert for central line dressing changes in the Neonatal Intensive Care Unit.","authors":"Lindsey A Knake, Rachel Asbury, Shannon Penisten, Nathan Meyer, Keith Burrell, Rebecca Chuffo Davila, Adam Wright, James M Blum","doi":"10.1055/a-2394-4462","DOIUrl":"https://doi.org/10.1055/a-2394-4462","url":null,"abstract":"<p><strong>Background: </strong>Interruptive alerts are known to be associated with clinician alert fatigue, and poorly performing alerts should be evaluated for alternative solutions. An interruptive alert to remind clinicians about a required peripherally inserted central catheter (PICC) dressing change within the first 48-hours after placement resulted in 617 firings in a 6-month period with only 11 (1.7%) actions taken from the alert.</p><p><strong>Objective: </strong>To enhance a poorly functioning interruptive alert by converting it to a non-interruptive alert aiming to improve compliance with the institutional PICC dressing change protocol. The primary outcome was to measure the percentage of initial PICC dressing changes that occurred beyond the recommended 48-hour timeframe after PICC placement. Secondary outcomes included measuring the time to first dressing change and, qualitatively, if this solution could replace the manual process of maintaining a physical list of patients.</p><p><strong>Methods: </strong>A clinical informatics team met with stakeholders to evaluate the clinical workflow and identified an additional need to track which patients qualified for dressing changes. A non-interruptive patient column clinical decision support (CDS) tool was created to replace an interruptive alert. A pre-post intervention mixed-methods cohort study was conducted between January 2022 - November 2022.</p><p><strong>Results: </strong>The number of patients with overdue PICC dressing changes decreased from 21.9% (40/183) to 7.8% (10/128) of eligible patients (p <0.001), and mean time to first PICC dressing changes also significantly decreased from 40.8 hours to 30.7 hours (p = 0.02). There was universal adoption of the CDS tool, and clinicians no longer used the manual patient list.</p><p><strong>Conclusions: </strong>While previous studies have reported that non-interruptive CDS may not be as effective as interruptive CDS, this case report demonstrates that developing a population-based CDS in the patient list column that provides an additional desired functionality to clinicians may result in improved adoption of CDS.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Structured Social-Media Health Support intervention Program after Bariatric Surgery.","authors":"Orly Tamir, Hassan Kais, Moran Accos Carmel, Tatyana Kolobov, Gideon Matthews, Aviva Lipsitz, Yuval Shalev Many, Sigal Benton, Arriel Benis","doi":"10.1055/a-2395-3357","DOIUrl":"https://doi.org/10.1055/a-2395-3357","url":null,"abstract":"<p><strong>Background: </strong>Social media networks have been found to provide emotional, instrumental, and social support, which may contribute to improved adherence to post-bariatric surgery care recommendations.</p><p><strong>Objectives: </strong>To evaluate the impact of an online social media-based, healthcare professional-led, educational and support program on patients' long-term engagement with and adherence to follow-up guidelines, self-care recommendations, and weight management after bariatric surgery.</p><p><strong>Methods: </strong>An observational cohort study, employing mixed methods, accompanied a 12-week interactive, structured, social-media psychoeducational intervention program delivered on Facebook. Program participants, who had undergone one bariatric surgery within the past 1-7 years and were at least 18 years old at the time of surgery, were invited to join the program via posts online. Interested individuals were provided information about the program and the accompanying evaluation study, and those who met requirements completed study questionnaires before and after the program. Questionnaires included demographic and anthropometric information; postoperative recommendations received and their clarity and implementation; attitudes towards recommendation adherence; and well-being. Daily system data on program engagement were collected from the Facebook website.</p><p><strong>Results: </strong>Of the 214 participants enrolled in the program, 101 (80.2% female, mean age 43.8±9.1 years and mean BMI 30.2±6.8 kg/m2, 1-7 years after bariatric surgery) completed both baseline and end-of-program questionnaires and were included in the analysis. Following the program, improvements were observed in most aspects of participants' adherence to postoperative recommendations and well-being. Close to half of the participants (44.6%) reported reaching their postoperative target weight at the end of the program or maintaining it throughout the program. Video posts drew higher participant engagement than other media, and content about proteins received the highest number of reactions. However, participants' active engagement gradually declined over time.</p><p><strong>Conclusions: </strong>Interactive health support on social media can positively enhance patient engagement, adherence to treatment recommendations, health outcomes, and overall well-being.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining documentation burden (DocBurden) and excess DocBurden for all health professionals: A scoping review.","authors":"Deborah R Levy, Jennifer Withall, Rebecca Grochow Mishuris, Vicky Tiase, Courtney J Diamond, Brian Douthit, Monika Grabowska, Rachel Lee, Amanda Moy, Patricia Sengstack, Julia Adler-Milstein, Don E Detmer, Kevin B Johnson, James J Cimino, Sarah T Corley, Judy Murphy, Trent Rosenbloom, Kenrick Cato, Sarah Collins Rossetti","doi":"10.1055/a-2385-1654","DOIUrl":"https://doi.org/10.1055/a-2385-1654","url":null,"abstract":"<p><strong>Objective: </strong>Efforts to reduce documentation burden (DocBurden) for all health professionals (HP) are aligned with national initiatives to improve clinician wellness and patient safety. Yet DocBurden has not been precisely defined, limiting national conversations and rigorous, reproducible, and meaningful measures. Increasing attention to DocBurden motivated this work to establish a standard definition of DocBurden, with the emergence of excessive DocBurden as a term.</p><p><strong>Methods: </strong>We conducted a scoping review of DocBurden definitions and descriptions, searching six databases for scholarly, peer-reviewed, and gray literature sources, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extensions for Scoping Review (PRISMA-ScR) guidance. For the concept clarification phase of work, we used the American Nursing Informatics Association (ANIA)'s 6-Domains of Burden Framework.</p><p><strong>Results: </strong>A total of 153 articles were included based on a priori criteria. Most articles described a focus on DocBurden, but only 18% (n=28) provided a definition. We define excessive DocBurden as the stress and unnecessarily heavy work a HP or healthcare team experiences when usability of documentation systems and documentation activities (i.e., generation, review, analysis and synthesis of patient data) are not aligned in support of care delivery. A negative connotation was attached to burden without a neutral state in included sources, which does not align with dictionary definitions of burden.</p><p><strong>Conclusions: </strong>Existing literature does not distinguish between a baseline or required task load to conduct patient care resulting from usability issues(DocBurden), and the unnecessarily heavy tasks and requirements that contribute to excessive DocBurden. Our definition of excessive DocBurden explicitly acknowledges this distinction, to support development of meaningful measures for understanding and intervening on excessive DocBurden locally, nationally and internationally.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Special Issue on Informatics Education: Pedagogical Principles in Implementing a Data Visualization Project in an Undergraduate Public Health Informatics Course.","authors":"John Robert Bautista","doi":"10.1055/a-2385-1544","DOIUrl":"https://doi.org/10.1055/a-2385-1544","url":null,"abstract":"<p><p>Background The Applied Public Health Informatics Competency Model lists \"data analysis, visualization, and reporting\" as one of the eight competencies when teaching public health informatics. Thus, public health informatics students need to develop knowledge and skills in visualizing public health data. Unfortunately, there is limited work that discusses pedagogical principles that could guide the implementation of pedagogical activities related to data visualization in public health informatics. Objective To introduce, discuss, and reflect on pedagogical principles that were implemented for a data visualization project in an undergraduate public health informatics course. Method A reflective teaching approach was used to guide the discussion and reflection on how pedagogical principles were implemented for a data visualization project in an undergraduate public health informatics course. The generic implementation framework (i.e., pre-implementation, implementation, and post-implementation) was used to organize the discussion of the course's implementation. Implementation Four pedagogical principles were implemented as part of a data visualization project in an undergraduate public health informatics course: scaffolding (i.e., outputs build on top of each other), constructivism (i.e., students apply knowledge and work in teams to create a dashboard), critical consciousness (i.e., embedding social determinants of health in their dashboard), and equity and inclusion (i.e., using a free data visualization software that is easy to use for beginners and is used by public health institutions). Post-implementation reflection revealed areas of improvement, such as enhancing group advising, adding more SDOH variables in the dashboard, and plans for scalability. Conclusion A data visualization project in an undergraduate public health informatics course could benefit from implementing multiple pedagogical principles. Overall, creating dashboards can be a learning tool to enhance data visualization skills among undergraduate public health informatics students. Dashboards can also emphasize the impact of health disparities and inequities in public health by incorporating principles of social determinants of health.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EHR Documentation and Referrals for Intimate Partner Violence and Sexual Assault.","authors":"Joshua E Richardson, Jaclyn Houston-Kolnik, Stefany Ramos, Devin Oxner, Paige Presler-Jur","doi":"10.1055/a-2381-3487","DOIUrl":"https://doi.org/10.1055/a-2381-3487","url":null,"abstract":"<p><strong>Background: </strong>Hospital settings provide a unique opportunity to screen for interpersonal violence (IPV) and sexual assault (SA) yet often lack health IT solutions for generating reliable and valid medico-legal documentation via forensic reports.</p><p><strong>Objectives: </strong>The objective of the project was to evaluate a pilot, technology \"tool\" for documenting cases of IPV and SA that could support forensic nurse examiners and related stakeholders in generating high quality documentation and coordinating victim support services.</p><p><strong>Methods: </strong>The tool was a digital health intervention implemented for use among forensic nurse examiners, law enforcement, victim support organizations, and more within four counties of California. We conducted a mixed-methods pilot study that captured data around the adoption, use, and impact of having access to the newly implemented tool.</p><p><strong>Results: </strong>The tool successfully went live in all four pilot counties at different time points with different proportions of use by county and form type: exams, referrals, addenda, risk assessments, and other. Participants were motivated to use the tool out of a perceived need for data handling functionalities that went beyond traditional manual (paper) means. Key functionalities included body mapping, data quality controls within validated forms, attaching addenda to already existing case reports, and the means to distribute data to external recipients. Further study and development are needed on functions to incorporate into body maps and forms, and understanding the information needs of law enforcement and victim support organizations.</p><p><strong>Conclusions: </strong>Our evaluation demonstrated the feasibility and acceptability of a health IT tool to support forensic nurse documentation of IPV and SA, and direct information to multiple legal and support-related stakeholders. Areas of future development include integrating IPV and SA-related data standards for digitized forms, enhancements to the body mapping feature, and understanding the needs of those who receive digital data from forensic nurse examiners within the tool.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multitasking during medication management in a nursing home: A time motion study.","authors":"Yu Jin Kang, Christine Mueller, Joseph E Gaugler, Karen A Monsen","doi":"10.1055/a-2379-7206","DOIUrl":"https://doi.org/10.1055/a-2379-7206","url":null,"abstract":"<p><strong>Background: </strong>Multitasking, defined as performing two or more interventions simultaneously, increases the cognitive burden of clinicians. This may, in turn, lead to higher risk of medication and procedural errors. Time motion study (TMS) data for nurses in nursing homes revealed an extensive amount of multitasking while managing medications. Further investigation of multitasked nursing interventions will provide a foundation for optimizing medication management workflows.</p><p><strong>Objectives: </strong>Using a continuous observational TMS method, this study aimed to describe pairs of multitasked nursing interventions associated with medication management interventions, including preparing and administering medications, assessing medication effects, instructing on medications, and documenting medication administration.</p><p><strong>Methods: </strong>An external nurse observer used 57 pre-defined Omaha System nursing interventions embedded within TimeCaT (version 3.9) TMS data recording software to collect observation data in a single nursing home. A total of 120 hours of time-stamped observation data from nine nurses was downloaded from TimeCaT and analyzed using descriptive and inferential statistics.</p><p><strong>Results: </strong>The majority (74%) of medication management interventions were multitasked, resulting in 2,003 pairs of multitasked interventions. Of the 57 Omaha System nursing interventions, 35 were involved in these multitasking pairs. When nurses multitasked, the average duration of medication preparation was longer (non-multitasked: 81 seconds; multitasked: 162 seconds, p<0.05), while the average duration of medication administration record documentation was shorter (non-multitasked: 93 seconds; multitasked: 66 seconds, p<0.05).</p><p><strong>Conclusions: </strong>The findings reveal the complexity of medication management in nursing homes with numerous and diverse multitasking pairs. Findings provide a platform for in-depth study of medication management multitasking in the clinical context, and inform future efforts to create clinical and informatics solutions to optimize medication management workflow. This method may be also applied to examine medication management and multitasking in other clinical settings.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fellows of the American Medical Informatics Association (FAMIA): Looking Back and Looking Ahead.","authors":"Laura Heermann Langford, Kate Fultz Hollis, Margo Edmunds, Allison B McCoy, Eric S Hall, Jeffrey A Nielson, Sarah Collins Rosetti","doi":"10.1055/s-0044-1788658","DOIUrl":"10.1055/s-0044-1788658","url":null,"abstract":"<p><strong>Background: </strong> Over the past 30 years, the American Medical Informatics Association (AMIA) has played a pivotal role in fostering a collaborative community for professionals in biomedical and health informatics. As an interdisciplinary association, AMIA brings together individuals with clinical, research, and computer expertise and emphasizes the use of data to enhance biomedical research and clinical work. The need for a recognition program within AMIA, acknowledging applied informatics skills by members, led to the establishment of the Fellows of AMIA (FAMIA) Recognition Program in 2018.</p><p><strong>Objectives: </strong> To outline the evolution of the FAMIA program and shed light on its origins, development, and impact. This report explores factors that led to the establishment of FAMIA, considerations affecting its development, and the objectives FAMIA seeks to achieve within the broader context of AMIA.</p><p><strong>Methods: </strong> The development of FAMIA is examined through a historical lens, encompassing key milestones, discussions, and decisions that shaped the program. Insights into the formation of FAMIA were gathered through discussions within AMIA membership and leadership, including proposals, board-level discussions, and the involvement of key stakeholders. Additionally, the report outlines criteria for FAMIA eligibility and the pathways available for recognition, namely the Certification Pathway and the Long-Term Experience Pathway.</p><p><strong>Results: </strong> The FAMIA program has inducted five classes, totaling 602 fellows. An overview of disciplines, roles, and application pathways for FAMIA members is provided. A comparative analysis with other fellow recognition programs in related fields showcases the unique features and contributions of FAMIA in acknowledging applied informatics.</p><p><strong>Conclusion: </strong> Now in its sixth year, FAMIA acknowledges the growing influence of applied informatics within health information professionals, recognizing individuals with experience, training, and a commitment to the highest level of applied informatics and the science associated with it.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11305823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a Pharmacist-Designed Clinical Decision Support System on Antimicrobial Stewardship.","authors":"Miguel Ángel Amor-García, Esther Chamorro-de-Vega, Carmen Guadalupe Rodríguez-González, Irene Iglesias-Peinado, Raquel Moreno-Díaz","doi":"10.1055/a-2341-8823","DOIUrl":"10.1055/a-2341-8823","url":null,"abstract":"<p><strong>Background: </strong> Clinical decision support systems (CDSSs) are computer applications, which can be applied to give guidance to practitioners in antimicrobial stewardship (AS) activities; however, further information is needed for their optimal use.</p><p><strong>Objectives: </strong> Our objective was to analyze the implementation of a CDSS program in a second-level hospital, describing alerts, recommendations, and the effects on consumption and clinical outcomes.</p><p><strong>Methods: </strong> In October 2020, a pharmacist-driven CDSS designed for AS was implemented in a second-level hospital. The program provides a list of alerts related to antimicrobial treatment and microbiology, which were automatized for revision by the AS professionals. To analyze the implementation of the CDSS, a pre-post-intervention, retrospective study was designed. AS-triggered alerts and recommendations (total number and rate of acceptance) were compiled. The effect of the CDSS was measured using antimicrobial consumption, duration of antimicrobial treatments, in-hospital mortality, and length of stay (LOS) for patients admitted for infectious causes.</p><p><strong>Results: </strong> The AS team revised a total of 7,543 alerts and 772 patients had at least one recommendation, with an acceptance rate of 79.3%. Antimicrobial consumption decreased from 691.1 to 656.8 defined daily doses (DDD)/1,000 beds-month (<i>p</i> = 0.04) and the duration of antimicrobial treatment from 3.6 to 3.3 days (<i>p</i> < 0.01). In-hospital mortality decreased from 6.6 to 6.2% (<i>p</i> = 0.46) and mean LOS from 7.2 to 6.2 days (<i>p</i> < 0.01).</p><p><strong>Conclusion: </strong> The implementation of a CDSS resulted in a significant reduction of antimicrobial DDD, duration of antimicrobial treatments, and hospital LOS. There was no significant difference in mortality.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141301946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}