Evidence map›Paper›PMID 31373352›Full record

ArticleJournal of the American Medical Informatics Association : JAMIA2019

Importance of clinical decision support system response time monitoring: a case report.

David Rubins, Adam Wright, Tarik Alkasab, M Stephen Ledbetter, Amy Miller, Rajesh Patel, Nancy Wei, Gianna Zuccotti, Adam Landman

Abstract read
In one paragraph

Article in Journal of the American Medical Informatics Association : JAMIA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. A scoping review of rule-based clinical decision support malfunctions.Journal of the American Medical Informatics Association : JAMIA · 2024
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

David RubinsDepartment of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Adam WrightDepartment of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Tarik AlkasabHarvard Medical School, Boston, Massachusetts, USA.
M Stephen LedbetterDepartment of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Amy MillerDepartment of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Rajesh PatelDepartment of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Nancy WeiHarvard Medical School, Boston, Massachusetts, USA.
Gianna ZuccottiDepartment of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Adam LandmanDepartment of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Funding

Improving clinical decision support reliability using anomaly detection methodsR01LM011966 · NLM · VANDERBILT UNIVERSITY MEDICAL CENTER · PI WRIGHT, ADAM T · 2014 to 2017
$2.4M
NLM NIH HHS R01 LM011966
6 · The paper itself

Abstract

Clinical decision support (CDS) systems are prevalent in electronic health records and drive many safety advantages. However, CDS systems can also cause unintended consequences. Monitoring programs focused on alert firing rates are important to detect anomalies and ensure systems are working as intended. Monitoring efforts do not generally include system load and time to generate decision support, which is becoming increasingly important as more CDS systems rely on external, web-based content and algorithms. We report a case in which a web-based service caused significant increase in the time to generate decision support, in turn leading to marked delays in electronic health record system responsiveness, which could have led to patient safety events. Given this, it is critical to consider adding decision support-time generation to ongoing CDS system monitoring programs.

Indexed as

Cloud ComputingDecision Support Systems, ClinicalElectronic Health RecordsHumansMedical Order Entry SystemsOrganizational Case StudiesTime Factorsclinical decision supportclinical decision support monitoringcloud-based integrationcomputerized provider order entrysystem performance monitoring

Identifiers

PMID31373352
PMCPMC6798567

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.