Automation, Decision Support, and Expert Systems in Nephrology

Document Type

Article

Publication Date

1-1-2008

Publication Title

Advances in Chronic Kidney Disease

Abstract

Increasing data suggest that errors in medicine occur frequently and result in substantial harm to the patient. The Institute of Medicine report described the magnitude of the problem, and public interest in this issue, which was already large, has grown. The traditional approach in medicine has been to identify the persons making the errors and recommend corrective strategies. However, it has become increasingly clear that it is more productive to focus on the systems and processes through which care is provided. If these systems are set up in ways that would both make errors less likely and identify those that do occur and, at the same time, improve efficiency, then safety and productivity would be substantially improved. Clinical decision support systems (CDSSs) are active knowledge systems that use 2 or more items of patient data to generate case specific recommendations. CDSSs are typically designed to integrate a medical knowledge base, patient data, and an inference engine to generate case specific advice. This article describes how automation, templating, and CDSS improve efficiency, patient care, and safety by reducing the frequency and consequences of medical errors in nephrology. We discuss practical applications of these in 3 settings: a computerized anemia-management program (CAMP©, Henry Ford Health, Detroit, MI), vascular access surveillance systems, and monthly capitation notes in the hemodialysis unit. © 2008 National Kidney Foundation, Inc.

PubMed ID

18155109

Volume

15

Issue

1

First Page

42

Last Page

55

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