Topic 3 DQ 1 Responses

Response to Classmate 1

Hello,

Thank you for the great post. You provide valuable insights into the various applications

of clinical decision support systems (CDSSs). You also adequately covered alert fatigue, a

primary concern associated with CDSSs. Several computerized and non-computerized tools and

interventions are included in clinical decision support (CDS). To fully benefit from electronic

health records and automated physician order entry, high-quality clinical decision support

systems (CDSS), also known as computerized CDS, are required (Wasylewicz et al., 2019). A

CDSS can consider all data in the EHR, making it feasible to recognize changes outside the

purview of the professional and recognize changes particular to a particular patient within

reasonable bounds. However, it is crucial to comprehend the fundamental requirements of these

systems to use CDSS in practice because inappropriate implementation and configuration

contribute to multiple unnecessary alerts that cause alert fatigue, which is detrimental to the

quality of care and patient safety (Olakotan & Mohd Yusof, 2021). A CDSS produces a large

number of unneeded warnings that impede clinical workflow. As a result, clinicians turn off,

disable, or disregard signals, endangering the safety of their patients. Therefore, it is necessary to

assess the efficacy and suitability of CDSS alerts.

References

Olakotan, O. O., & Mohd Yusof, M. (2021). The appropriateness of clinical decision support

systems alerts in supporting clinical workflows: a systematic review. Health informatics

journal, 27(2), 14604582211007536.

Wasylewicz, A. T. M., & Scheepers-Hoeks, A. M. J. W. (2019). Clinical decision support

systems. Fundamentals of clinical data science, 153-169.

Response to Ashley Kamer

Hello, Kamer.

Thank you for an elaborative and insightful discussion. I learned a lot from your post

regarding computerized provider order entry and its implications for healthcare. I agree that

CPOE has revolutionized healthcare delivery, particularly medication orders, helping reduce

medication errors that threaten the quality of care and patient safety. Clinical data, such as those

found in electronic health records (EHRs), illness registries, patient surveys, and information

exchanges, are both growing in amount and quality (Wasylewicz et al., 2019). However,

digitalization and big data do not always equate to better patient care. According to numerous

studies, adopting merely an EHR and CPOE significantly reduced the frequency of some errors

while substantially increasing the number of others. Therefore, if healthcare organizations are to

benefit from electronic health records and CPOE fully, high-quality clinical decision support is

crucial. Specifically, addressing alert fatigue is critical. Most CPOE warnings, including

"critical" alerts that warn of potentially serious injury, are typically ignored by clinicians

(AHRQ, 2019). More research needs to be done on warnings of other kinds, but these settings

are likely to have high rates of overriding or disregarding warnings.

References

AHRQ. (2019, September 7). Alert fatigue. Patient Safety Network.

https://psnet.ahrq.gov/primer/alert-fatigue
Wasylewicz, A. T. M., & Scheepers-Hoeks, A. M. J. W. (2019). Clinical decision support

systems. Fundamentals of clinical data science, 153-169.