The safety and quality of decision support systems.

摘要: Objectives: The use of clinical decision support systems (CDSS) can improve the overall safety and quality health care delivery, but may also introduce machine-related errors. Recent concerns about potential for CDSS to harm patients have generated much debate, there is little research available identify nature such errors, or quantify their frequency impact. Methods: A review recent literature into electronic prescribing systems, as well related in support. Results:: : There seems be some evidence variation outcomes using CDSS, most likely reflecting variations setting, culture, training organizational process, independent technical variables. preliminary that poorly implemented lead increased mortality settings. Studies US, UK Australia found commercial often fail uniformly detect significant drug interactions, probably because errors knowledge base. Electronic medication management generate new types error user-interface design, events workplace distraction affecting actions system users. Another source influenced are automation biases, including omission where individuals miss important data does not prompt them notice them, commission do what aid tells do, even when this contradicts other data. Errors dismissal occur relevant alerts ignored. On-line result clinicians come an incorrect assessment evidence, possibly shaped part by cognitive biases. Conclusions:: effectiveness like all IT, cannot assessed purely evaluating usability performance software, outcome a complex set socio-technical interactions. deeper understanding these issues design which just intrinsically ‘safe’ safe hands busy resourced clinicians. Haux R, Kulikowski C, editors. IMIA Yearbook Medical Informatics 2006. Methods Inf Med 2006; 45 Suppl 1: S20-5.