Study: Customized CDS alerts better than vendor-supplied solution

Homegrown clinical decision support alerts may result in higher usage and improved clinical quality, according to a study in Infection Control and Hospital Epidemiology.

Researchers at the University of Pennsylvania Health System in Philadelphia studied the effectiveness of two CDS alert systems both designed to reduce the duration of urinary tract catheterizations. Both CDS systems included alerts for the provider to reassess the need for a urinary catheter if it had not been removed within the recommended timeframe. The homegrown alert was a simplified version of the vendor's CDS system, requiring just two mouse clicks to order the removal of the urinary catheter, as opposed to the seven mouse clicks required by the vendor solution.

Results showed just 2 percent of providers heeded the alert to remove the urinary catheter with the vendor-supplied CDS system, a rate that jumped to 15 percent with the CDS alert system developed in-house. Researchers concluded CDS use is highly dependent on its interface, and homegrown systems have a better chance at engaging providers than out-of-the-box solutions.

"By making the alert quicker and easier to use, we saw a dramatic increase in the number of catheters removed in patients who no longer needed them," said the study's lead author Charles A. Baillie, MD. "Fewer catheters means fewer infections, fewer days in the hospital, and even, fewer deaths. Not to mention the dollars saved by the health system in general."

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