Search PubMed⌕ Search

PubMed · 10635083

Using information systems to improve practice.

Abstract

Information systems are becoming a key tool for improving and measuring practice. They can improve care by providing decision support during routine care, by making important information more readily accessible, by pointing out redundancies, by suggesting alternatives, and by making guidelines accessible. Key domains, which are particularly amenable to such decision support, include drug prescribing, test ordering and implementation of critical pathways. In addition to their role in quality improvement, information systems can accomplish most quality measurement if key data are captured in coded form during the provision of routine care. These changes can help close the gap between knowledge and practice and promise to make the practice of evidence-based medicine a reality.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

D W Bates. 1999-12-11. Using information systems to improve practice.. https://pubmed.ncbi.nlm.nih.gov/10635083/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Effects of computerized physician order entry on prescribing practices.

BACKGROUND: Computerized order entry systems have the potential to prevent errors, to improve quality of care, and to reduce costs by providing feedback and suggestions to the physician as each order is entered. This study assesses the impact of an inpatient computerized physician order entry system on prescribing practices. METHODS: A time series analysis was performed at an urban academic medical center at which all adult inpatient orders are entered through a computerized system. When physicians enter drug orders, the computer displays drug use guidelines, offers relevant alternatives, and suggests appropriate doses and frequencies. RESULT: For medication selection, use of a computerized guideline resulted in a change in use of the recommended drug (nizatidine) from 15.6% of all histamine(2)-blocker orders to 81.3% (P<.001). Implementation of dose selection menus resulted in a decrease in the SD of drug doses by 11% (P<.001). The proportion of doses that exceeded the recommended maximum decreased from 2.1% before order entry to 0.6% afterward (P<.001). Display of a recommended frequency for ondansetron hydrochloride administration resulted in an increase in the use of the approved frequency from 6% of all ondansetron orders to 75% (P<.001). The use of subcutaneous heparin sodium to prevent thrombosis in patients at bed rest increased from 24% to 47% when the computer suggested this option (P<.001). All these changes persisted at 1- and 2-year follow-up analyses. CONCLUSION: Computerized physician order entry is a powerful and effective tool for improving physician prescribing practices.

Decision Support Systems, Clinical↗

An experimental electronic patient record for stroke patients. Part 1: situation analysis.

In this article the paper record and its position in work practices is discussed, and is related to the situation at an inpatient clinic for which an electronic patient record (EPR) is in development. In addition reported research on innovations is discussed. An analysis of 42 clinical paper records gave insight into existing problems with paper records. The current work practices were analysed based on two periods of observations in the ward and eight in-depth interviews with questions about their daily work, communication in the ward and the role of the paper record in communication. The results indicate that several problems described in the literature were recognised only for a part of the medical and nursing records. One probable cause of insufficient communication between health care workers appeared to be the internal organisation of the paper records. The fact that the experimental EPR system will be small-scaled, introduces specific problems regarding communication with other departments that still work with paper records. Nevertheless, we conclude that also an electronic patient record designed for a specific setting has the potential to improve record keeping and communication between health care workers.

Decision Support Systems, Clinical↗