Wadhwa R
Analysis of a failed clinical decision support system for management of congestive heart failure. [Journal Article]
AMIA Annu Symp Proc 2008.:773-7.
In order to increase compliance with The Joint Commissions Congestive Heart Failure Core Measures, a rule based clinical decision support system (CDSS) was developed and deployed at a community hospital in our health system. We evaluated performance of the CDSS in identifying patients with primary CHF and identified problems encountered with its introduction. Performance of the CDSS was compared against a manual review of records of patients with diagnosis of primary CHF. The CDSS performed with a sensitivity of 0.79 and PPV of 0.11. There were multiple alerts for majority of the patients (74%). The number of alerts for patients without primary CHF was large, and for a majority of patients (63%) physicians did not respond to alerts the first time. The CDSS performed poorly and was eventually withdrawn but provided insight into a subsequently successful method for managing CHF.
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