title: Medical decision support: experience with implementing the Arden Syntax at the Columbia-Presbyterian Medical Center.
abstract: We began implementation of a medical decision support system (MDSS) at the Columbia-Presbyterian Medical Center (CPMC) using the Arden Syntax in 1992. The Clinical Event Monitor which executes the Medical Logic Modules (MLMs) runs on a mainframe computer. Data are stored in a relational database and accessed via PL/I programs known as Data Access Modules (DAMs). Currently we have 18 clinical, 12 research and 10 administrative MLMs. On average, the clinical MLMs generate 50357 simple interpretations of laboratory data and 1080 alerts each month. The number of alerts actually read varies by subject of the MLM from 32.4% to 73.5%. Most simple interpretations are not read at all. A significant problem of MLMs is maintenance, and changes in laboratory testing and message output can impair MLM execution significantly. We are now using relational database technology and coded MLM output to study the process outcome of our MDSS.
authors.affiliation: Department of Medical Informatics, Columbia University, New York, New York, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Jenders
authors.forename: G
authors.initials: G
authors.lastname: Hripcsak
authors.forename: R V
authors.initials: RV
authors.lastname: Sideli
authors.forename: W
authors.initials: W
authors.lastname: DuMouchel
authors.forename: H
authors.initials: H
authors.lastname: Zhang
authors.forename: J J
authors.initials: JJ
authors.lastname: Cimino
authors.forename: S B
authors.initials: SB
authors.lastname: Johnson
authors.forename: E H
authors.initials: EH
authors.lastname: Sherman
authors.forename: P D
authors.initials: PD
authors.lastname: Clayton
mesh_terms: D000046:Academic Medical Centers; D001185:Artificial Intelligence; D003658:Decision Making, Computer-Assisted; D003661:Decision Support Techniques; D006751:Hospital Information Systems; D006801:Humans; D016347:Medical Records Systems, Computerized; D009519:New York City; D011381:Programming Languages