Framework for a clinical information system

Velde, Rudi Van de

doi:10.1016/s1386-5056(99)00062-3

Cited by 26 publications

(6 citation statements)

References 6 publications

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“…This pre-post study was conducted at the UZ Brussel, a 721-bed tertiary university hospital in Brussels, Belgium. The in-house developed software system "Primuz" is fully integrated within the workflow and provides different functionalities including CPOE and CDS for DDIs [26,35,36]. The knowledge base used for DDI checking is the commercially available DelphiCare® database [37].…”

Section: Design and Settingmentioning

confidence: 99%

Evaluation of context-specific alerts for potassium-increasing drug-drug interactions: A pre-post study

Muylle

Gentens

Dupont

et al. 2020

International Journal of Medical Informatics

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Objective: To investigate whether context-specific alerts for potassium-increasing drug-drug interactions (DDIs) in a clinical decision support system reduced the alert burden, increased alert acceptance, and had an effect on the occurrence of hyperkalemia. Materials and Methods:In the pre-intervention period all alerts for potassium-increasing DDIs were level 1 alerts advising absolute contraindication, while in the post-intervention period the same drug combinations could trigger a level 1 (absolute contraindication), a level 2 (monitor potassium values), or a level 3 alert (informative, not shown to physicians) based on the patient's recent laboratory value of potassium. Alert acceptance was defined as non-prescription or non-administration of the interacting drug combination for level 1 alerts and as monitoring of the potassium levels for level 2 alerts. Results:The alert burden decreased by 92.8%. The relative risk (RR) for alert acceptance based on prescription rates for level 1 alerts and monitoring rates for level 2 alerts was 15.048 (86.5% vs 5.7%; 95% CI 12.037 -18.811; P < 0.001). With alert acceptance for level 1 alerts based on actual administration and for level 2 alerts on monitoring rates, the RR was 3.597 (87.6% vs 24.4%; 95% CI 3.192 -4.053; P < 0.001).In the generalized linear mixed model the effect of the intervention on the occurrence of hyperkalemia was not significant (OR 1.091, 95% CI 0.172 -6.919). Conclusion:The proposed strategy seems effective to get a grip on the delicate balance between overand under alerting.

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Section: Design and Settingmentioning

confidence: 99%

Evaluation of context-specific alerts for potassium-increasing drug-drug interactions: A pre-post study

Muylle

Gentens

Dupont

et al. 2020

International Journal of Medical Informatics

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“…The in-house developed software system was introduced in 1994 [25,26]. This home-grown system, called the "Clinical Workstation", evolved further and is fully integrated within the workflow of various medical services.…”

Section: The Software Systemmentioning

confidence: 99%

Pilot evaluation of an optimized context-specific drug–drug interaction alerting system: A controlled pre-post study

Cornu

Steurbaut

Gentens³

et al. 2015

International Journal of Medical Informatics

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“…In 1988 Simborg (9) published a paper describing a standard known as HL7 for linking disparate systems. Since that time, systems that reflect this approach (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) have begun to emerge. We will now describe our experience with this approach.…”

Section: Resultsmentioning

confidence: 99%

Building a Comprehensive Clinical Information System from Components

Clayton¹,

Narus²,

Huff³

et al. 2003

Methods Inf Med

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Summary Objectives: To discuss the advantages and disadvantages of an interfaced approach to clinical information systems architecture. Methods: After many years of internally building almost all components of a hospital clinical information system (HELP) at Intermountain Health Care, we changed our architectural approach as we chose to encompass ambulatory as well as acute care. We now seek to interface applications from a variety of sources (including some that we build ourselves) to a clinical data repository that contains a longitudinal electronic patient record. Results: We have a total of 820 instances of interfaces to 51 different applications. We process nearly 2 million transactions per day via our interface engine and feel that the reliability of the approach is acceptable. Interface costs constitute about four percent of our total information systems budget. The clinical database currently contains records for 1.45 m patients and the response time for a query is 0.19sec. Discussion: Based upon our experience with both integrated (monolithic) and interfaced approaches, we conclude that for those with the expertise and resources to do so, the interfaced approach offers an attractive alternative to systems provided by a single vendor. We expect the advantages of this approach to increase as the costs of interfaces are reduced in the future as standards for vocabulary and messaging become increasingly mature and functional.

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Framework for a clinical information system

Cited by 26 publications

References 6 publications

Evaluation of context-specific alerts for potassium-increasing drug-drug interactions: A pre-post study

Evaluation of context-specific alerts for potassium-increasing drug-drug interactions: A pre-post study

Pilot evaluation of an optimized context-specific drug–drug interaction alerting system: A controlled pre-post study

Building a Comprehensive Clinical Information System from Components

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