Decision support systems
An algorithm-driven program combines hospital-wide inpatient screening for alcohol withdrawal risk, monitoring of at-risk patients, and medical treatment of symptoms, leading to more patients being diagnosed, fewer acute episodes of delirium, and improved care for patients experiencing such episodes.
Electronic alerts, patient education, and provider performance reports promote adherence to a guideline covering early elective inductions, leading to a significant decline in such inductions, shorter average labor, and fewer newborn complications.
Electronic alerts related to black box warnings did not affect overall physician prescribing habits in outpatient clinics; the alerts did influence prescribing related to warnings about the most serious potential drug–drug and drug–pregnancy interactions.
Through its commercial electronic medical record system, a large internal medicine practice provides physicians with unobtrusive reminders related to 16 standardized measures and makes it easy for them to order recommended tests or treatment or document legitimate exceptions, leading to better performance on these measures.
A fall prevention toolkit uses a computerized algorithm to assess the risk of falling, identify patient-specific risk factors, and design individualized interventions to reduce those risks, leading to fewer falls in the inpatient setting.
Providers use a computerized algorithm to classify inpatients as low, moderate, or high risk, and then prescribe anticoagulant (blood thinner) medication and/or mechanical devices as appropriate, leading to reduced incidence of venous thromboembolism.
Sexual health clinics offer patients the option of requesting an appointment for nonurgent conditions via a Web-based system; the program has proven quite popular with patients and, along with other initiatives, has enhanced the clinics' ability to offer appointments quickly and serve new patients.
Peer specialists and decision support aids help mental health clients identify preferences about their treatment and communicate these preferences to clinicians during consultations, leading to frequent use of shared decisionmaking, more effective and efficient visits, and high levels of client satisfaction.
A hospital-based telephone triage system allows patients to describe their symptoms to a nurse, who uses an algorithm to assess acuity and determine the best setting for treatment, leading to reductions in emergency department patient volumes, wait times, average length of stay, and walkouts.
Popup, color-coded alerts within an electronic health record moderately improve adherence to established guidelines in primary care practices serving pediatric patients with asthma.