Hospital-Based Decision Support

  • Peter J. Haug
  • Reed M. Gardner
  • R. Scott Evans
Part of the Health Informatics book series (HI)


Decision support technologies are becoming increasingly available to medical practitioners. In recent years, a variety of programs designed to assist with drug dosing, health maintenance, diagnosis and other clinically relevant decisions have been developed for the medical market. Increasing ease of access to personal computers is partially responsible for this growth. So is the interest in automated medical decision-making that has grown from an expanding awareness of the successes of medical computing.


Decision Support Nosocomial Infection Adverse Drug Event Adult Respiratory Distress Syndrome Hospital Information System 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Bleich HL. The computer as a consultant. N Engl J Med 1971; 284:141–146.PubMedCrossRefGoogle Scholar
  2. 2.
    McDonald CJ. Protocol-based computer reminders, the quality of care and the non-perfectibility of medicine. N Engl J Med 1976; 295:1351–1355.PubMedCrossRefGoogle Scholar
  3. 3.
    Tierney WM, Overhage JM, McDonald CJ. Toward electronic records that improve care. Ann Intern Med 1995; 122:725–726.PubMedCrossRefGoogle Scholar
  4. 4.
    Clayton PD, Sideli RV, Sengupta S. Open architecture and integrated information at Columbia-Presbyterian Medical Center. MD Comput 1992; 9:297–303.PubMedGoogle Scholar
  5. 5.
    Safran C, Herrmann F, Rind D et al. Computer-based support of clinical decision making. MD Comput 1990; 9:319–322.Google Scholar
  6. 6.
    Teich JM, Geisler MA, Cimermann DE et al. Design considerations in the BWH ambulatory medical record: features for maximum acceptance by clinicians. Proc Annu Symp Comput Appl Med Care 1990:735–739.Google Scholar
  7. 7.
    Geissbuhler A, Miller RA. A new approach to the implementation of direct care-provider order entry. Proc AMIA Fall Symp 1996:689–693.Google Scholar
  8. 8.
    Kuperman GJ, Gardner RM, Pryor TA. HELP: A Dynamic Hospital Information System. New York: Springer-Verlag, 1991.CrossRefGoogle Scholar
  9. 9.
    Pryor TA, Clayton PD, Haug PJ et al. Design of a knowledge driven HIS. Proc Annu Symp Comput Appl Med Care 1987:60–63.Google Scholar
  10. 10.
    Gardner RM, Cannon GH, Morris AH et al. Computerized blood gas interpretation and reporting system. IEEE Computer 1975; 8:39–45.CrossRefGoogle Scholar
  11. 11.
    Gardner RM. Computerized data management and decision making in critical care. Surg Clin N America 1985; 65:1041–1051.PubMedGoogle Scholar
  12. 12.
    Hulse RK, Clark SJ, Jackson JC et al. Computerized medication monitoring system. Am J Hosp Pharm 1976; 33:1061–1064.PubMedGoogle Scholar
  13. 13.
    Hripcsak G, Clayton PD, Pryor TA et al. The Arden syntax for medical logic modules. Proc Annu Symp Comput Appl Med Care 1990:200–204.Google Scholar
  14. 14.
    Haug PJ, Gardner RM, Tate KE et al. Decision support in medicine: examples from the HELP system. Comput Biomed Res 1994; 27:396–418.PubMedCrossRefGoogle Scholar
  15. 15.
    Wheeler LA, Brecher G, Sheiner LB. Clinical laboratory use in the evaluation of anemia. JAMA 1977; 238:2709–2714.PubMedCrossRefGoogle Scholar
  16. 16.
    Olsen DM, Kane RL, Proctor PH. A controlled trial of multiphasic screening. N Eng J Med 1976; 294:925–930.CrossRefGoogle Scholar
  17. 17.
    Bradshaw KE, Gardner RM, Pryor TA. Development of a computerized laboratory alerting system. Comput Biomed Res 1989; 22: 575–587.PubMedCrossRefGoogle Scholar
  18. 18.
    Tate KE, Gardner RM, Weaver LK. A computer laboratory alerting system. MD Comput 1990; 7:296–301.PubMedGoogle Scholar
  19. 19.
    Tate KE, Gardner RM. Computers, quality and the clinical laboratory: a look at critical value reporting. Proc Annu Symp Comput Appl Med Care 1993:193–197.Google Scholar
  20. 20.
    Tate KE, Gardner RM, Scherting K. Nurses, pagers, and patient-specific criteria: three keys to improved critical value reporting. Proc Annu Symp Comput Appl Med Care 1995:164–168.Google Scholar
  21. 21.
    Johnson DS, Ranzenberger J, Herbert RD et al. A computerized alert program for acutely ill patients. J Nurse Admin 1980; 10:26–35.CrossRefGoogle Scholar
  22. 22.
    Kuperman GJ, Teich JM, Bates DW et al. Detecting alerts, notifying the physician, and offering action items: a comprehensive alerting system. Proc AMIA Fall Symp 1996:704–708.Google Scholar
  23. 23.
    Van Schoonhoven P, Berkmann EM, Lehman R, Fromberg R, eds. Medical Staff Monitoring Functions—Blood Usage Review. Chicago: Joint Commission on Accreditation of Hospitals, 1987.Google Scholar
  24. 24.
    Gardner RM, Golubjatnikov OK, Laub RM et al. Computer-critiqued blood ordering using the HELP system. Comput Biomed Res 1990; 23:514–528.PubMedCrossRefGoogle Scholar
  25. 25.
    Lepage EF, Gardner RM, Laub RM et al. Improving blood transfusion practice: role of a computerized hospital information system. Transfusion 1992; 32:253–259.PubMedCrossRefGoogle Scholar
  26. 26.
    Gardner RM, Christiansen PD, Tate KE et al. Computerized continuous quality improvement methods used to optimize blood transfusions. Proc Annu Symp Comput Appl Med Care 1993:166–170.Google Scholar
  27. 27.
    Sittig DF, Pace NL, Gardner RM et al. Implementation of a computerized patient advise system using the HELP clinical information system. Comput Biomed Res 1989; 22:474–487.PubMedCrossRefGoogle Scholar
  28. 28.
    East TD, Henderson S, Morris AH et al. Implementation issues and challenges for computerized clinical protocols for management of mechanical ventilation in ARDS patients. Proc Annu Symp Comput Appl Med Care 1989:583–587.Google Scholar
  29. 29.
    Henderson S, East TD, Morris AH et al. Performance evaluation of computerized clinical protocols for management of arterial hypoxemia in ARDS patients. Proc Annu Symp Comput Appl Med Care 1989:588–592.Google Scholar
  30. 30.
    Morris AH, Wallace CJ, Menlove RL et al. A randomized clinical trial of pressure-controlled inverse ratio ventilation and extracorporeal CO2 removal for adult respiratory distress syndrome. Am J Respir Crit Care Med 1994; 149:295–305.PubMedCrossRefGoogle Scholar
  31. 31.
    Johnson JA, Bootman HL. Drug-related morbidity and mortality: a cost of illness model. Arch Intern Med 1995; 155:1949–1956.PubMedCrossRefGoogle Scholar
  32. 32.
    Classen DC, Pestotnik SL, Evans RS et al. Computerized surveillance of adverse drug events in hospital patients. JAMA 1991; 266: 2847–2851.PubMedCrossRefGoogle Scholar
  33. 33.
    Evans RS, Pestotnik SL, Classen DC et al. Development of a computerized adverse drug event monitor. Proc Annu Symp Comput Appl Med Care 1991:23–27.Google Scholar
  34. 34.
    Naranjo CA, Busto U, Sellers EM et al. A method for estimating the probability of adverse drug reacrions. Clin Pharmacol Ther 1981; 30:239–245.PubMedCrossRefGoogle Scholar
  35. 35.
    Classen DC, Pestotnik SL, Evans RS et al. Adverse drug events in hospitalized patients: excess length of stay, extra costs, and attributable mortality. JAMA 1997; 277:301–306.PubMedCrossRefGoogle Scholar
  36. 36.
    Evans RS, Larsen RA, Burke JP et al. Computer surveillance of hospital-acquired infections and antibiotic use. JAMA 1986; 256: 1007–1011.PubMedCrossRefGoogle Scholar
  37. 37.
    Evans RS, Burke JP, Pestotnik SL et al. Prediction of hospital infections and selection of antibiotics using an automated hospital data base. Proc Annu Symp Comput Appl Med Care 1990:663–667.Google Scholar
  38. 38.
    Pestotnik SL, Classen DC, Evans RS et al. Implementing antibiotic practice guidelines through computer-assisted decision support: clinical and financial outcomes. Ann Int Med 1996; 124:884–890.PubMedCrossRefGoogle Scholar
  39. 39.
    Evans RS, Classen DC, Pestotnik SL et al. A decision support tool for antibiotic therapy. Proc Annu Symp Comput Appl Med Care 1995:651–655.Google Scholar
  40. 40.
    Ledley RS, Lusted LB. Reasoning foundations of medical diagnosis. Science 1959; 130:9–21.PubMedCrossRefGoogle Scholar
  41. 41.
    Warner HR, Rutherford BD, Houtchens B. A sequential Bayesian approach to history taking and diagnosis. Comput Biomed Res 1972; 5:256–262.PubMedCrossRefGoogle Scholar
  42. 42.
    Haug PJ, Warner HR, Clayton PD et al. A decision-driven system to collect the patient history. Comput Biomed Res 1987; 20:193–207.PubMedCrossRefGoogle Scholar
  43. 43.
    Haug PJ, Rowe KG, Rich T et al. A comparison of computer-administered histories. Proc Annu Conf—Am Assoc Med Syst Inf, Conf. 1988:21–25.Google Scholar
  44. 44.
    Herman PG, Gerson DE, Hessel SJ et al. Disagreements in chest roentgen interpretation. Chest 1975; 68:278–282.PubMedCrossRefGoogle Scholar
  45. 45.
    Yerushalmy J. Reliability of chest radiology in the diagnosis of pulmonary lesions. Am J Surg 1955; 89:231–240.PubMedCrossRefGoogle Scholar
  46. 46.
    Koran LM. The reliability of clinical methods, data, and judgments (second of two parts). N Engl J Med 1975; 293:695–701.PubMedCrossRefGoogle Scholar
  47. 47.
    Rhea JT, Potsaid MS, DeLuca SA. Errors of interpretation as elicited by a quality audit of an emergency radiology facility. Radiol 1979; 132:277–280.Google Scholar
  48. 48.
    Raines CJ, McFarlane DV, Wall C. Audit procedures in the national breast screening study: mammography interpretation. J Can Assoc Radiol 1986; 37:256–260.Google Scholar
  49. 49.
    Shannon CE, Weaver W. The Mathematical Theory of Communication. Urbana: University of Illinois Press, 1949.Google Scholar
  50. 50.
    Haug PJ, Clayton PD, Tocino I et al. Chest radiography: a tool for the audit of report quality. Radiol 1991; 180:271–276.Google Scholar
  51. 51.
    Haug PJ, Pryor TA, Frederick PR. Integrating radiology and hospital information systems: the advantage of shared data. Proc Annu Symp Comput Appl Med Care 1992:187–191.Google Scholar

Copyright information

© Springer Science+Business Media New York 1999

Authors and Affiliations

  • Peter J. Haug
  • Reed M. Gardner
  • R. Scott Evans

There are no affiliations available

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