Perioperative Information Systems: Opportunities to Improve Delivery of Care and Clinical Outcomes in Cardiac and Vascular Surgery

Freundlich, Robert E.; Ehrenfeld, Jesse M.

doi:10.1053/j.jvca.2017.11.002

Cited by 10 publications

(5 citation statements)

References 67 publications

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“…11 Through the MPOG infrastructure, perioperative data are aggregated via automated extraction followed by clinician validation, including a preoperative anesthesia history and physical; intraoperative observations (eg, physiologic monitors, ventilator data); interventions (eg, airway documentation, medications, fluids/blood products, cardiopulmonary bypass start/stop); providers; laboratory values; and administrative and billing data. 12 Highly structured, deidentified data are transmitted to a central repository on a monthly basis and are made accessible to researchers as regulated by a committee of representatives from all participating institutions and to quality improvement programs as governed by the MPOG Quality Improvement Committee. At selected MPOG institutions, perioperative EHR data are integrated with surgical registry data (eg, the Society of Thoracic Surgeons Adult Cardiac Surgery and General Thoracic Surgery databases and the American College of Surgeons National Surgical Quality Improvement Program), enabling associations to be studied between perioperative care processes available via MPOG and surgical outcomes available via surgical outcomes registries.…”

Section: The Multicenter Perioperative Outcomes Group As a Learning Hmentioning

confidence: 99%

Making Sense of Big Data to Improve Perioperative Care: Learning Health Systems and the Multicenter Perioperative Outcomes Group

Mathis

Dubovoy

Caldwell

et al. 2020

Journal of Cardiothoracic and Vascular Anesthesia

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Section: The Multicenter Perioperative Outcomes Group As a Learning Hmentioning

confidence: 99%

Making Sense of Big Data to Improve Perioperative Care: Learning Health Systems and the Multicenter Perioperative Outcomes Group

Mathis

Dubovoy

Caldwell

et al. 2020

Journal of Cardiothoracic and Vascular Anesthesia

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“…Additional components to perioperative information systems are used to manage operating room staffing, patient flow, and case scheduling. [ 42 ]. Core competencies of clinical informaticians in the perioperative environment include understanding these systems and leading efforts at system implementation and ongoing optimization.…”

Section: Management Of Perioperative Information Systemsmentioning

confidence: 99%

The Case for the Anesthesiologist-Informaticist

Lee¹,

Hitt²,

Hobika³

et al. 2022

JMIR Perioper Med

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Health care has been transformed by computerization, and the use of electronic health record systems has become widespread. Anesthesia information management systems are commonly used in the operating room to maintain records of anesthetic care delivery. The perioperative environment and the practice of anesthesia generate a large volume of data that may be reused to support clinical decision-making, research, and process improvement. Anesthesiologists trained in clinical informatics, referred to as informaticists or informaticians, may help implement and optimize anesthesia information management systems. They may also participate in clinical research, management of information systems, and quality improvement in the operating room or throughout a health care system. Here, we describe the specialty of clinical informatics, how anesthesiologists may obtain training in clinical informatics, and the considerations particular to the subspecialty of anesthesia informatics. Management of perioperative information systems, implementation of computerized clinical decision support systems in the perioperative environment, the role of virtual visits and remote monitoring, perioperative informatics research, perioperative process improvement, leadership, and change management are described from the perspective of the anesthesiologist-informaticist.

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“…26 Intraoperative medication-related CDS on the market currently is often limited to simple reminders (e.g., to redose antibiotics, monitor blood glucose, or administer postoperative nausea prophylaxis). [27][28][29] Poor CDS design can lead to negative consequences, such as AMEs and increased provider burden. [31][32][33] While there is a paucity of data on user-centered design of intraoperative CDS applications, the usability of CDS applications has been well studied outside of the OR.…”

Section: Background and Significancementioning

confidence: 99%

Development of a Perioperative Medication-Related Clinical Decision Support Tool to Prevent Medication Errors: An Analysis of User Feedback

et al. 2021

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Objectives Medication use in the perioperative setting presents many patient safety challenges that may be improved with electronic clinical decision support (CDS). The objective of this paper is to describe the development and analysis of user feedback for a robust, real-time medication-related CDS application designed to provide patient-specific dosing information and alerts to warn of medication errors in the operating room (OR). Methods We designed a novel perioperative medication-related CDS application in four phases: (1) identification of need, (2) alert algorithm development, (3) system design, and (4) user interface design. We conducted group and individual design feedback sessions with front-line clinician leaders and subject matter experts to gather feedback about user requirements for alert content and system usability. Participants were clinicians who provide anesthesia (attending anesthesiologists, nurse anesthetists, and house staff), OR pharmacists, and nurses. Results We performed two group and eight individual design feedback sessions, with a total of 35 participants. We identified 20 feedback themes, corresponding to 19 system changes. Key requirements for user acceptance were: Use hard stops only when necessary; provide as much information as feasible about the rationale behind alerts and patient/clinical context; and allow users to edit fields such as units, time, and baseline values (e.g., baseline blood pressure). Conclusion We incorporated user-centered design principles to build a perioperative medication-related CDS application that uses real-time patient data to provide patient-specific dosing information and alerts. Emphasis on early user involvement to elicit user requirements, workflow considerations, and preferences during application development can result in time and money efficiencies and a safer and more usable system.

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Perioperative Information Systems: Opportunities to Improve Delivery of Care and Clinical Outcomes in Cardiac and Vascular Surgery

Cited by 10 publications

References 67 publications

Making Sense of Big Data to Improve Perioperative Care: Learning Health Systems and the Multicenter Perioperative Outcomes Group

Making Sense of Big Data to Improve Perioperative Care: Learning Health Systems and the Multicenter Perioperative Outcomes Group

The Case for the Anesthesiologist-Informaticist

Development of a Perioperative Medication-Related Clinical Decision Support Tool to Prevent Medication Errors: An Analysis of User Feedback

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