title: Patient safety in guideline-based decision support for hypertension management: ATHENA DSS.
abstract: The Institute of Medicine recently issued a landmark report on medical error.1 In the penumbra of this report, every aspect of health care is subject to new scrutiny regarding patient safety. Informatics technology can support patient safety by correcting problems inherent in older technology; however, new information technology can also contribute to new sources of error. We report here a categorization of possible errors that may arise in deploying a system designed to give guideline-based advice on prescribing drugs, an approach to anticipating these errors in an automated guideline system, and design features to minimize errors and thereby maximize patient safety. Our guideline implementation system, based on the EON architecture, provides a framework for a knowledge base that is sufficiently comprehensive to incorporate safety information, and that is easily reviewed and updated by clinician-experts.
authors.affiliation: VA Palo Alto Health Care Systems, CA, USA.
authors.forename: M K
authors.initials: MK
authors.lastname: Goldstein
authors.forename: B B
authors.initials: BB
authors.lastname: Hoffman
authors.forename: R W
authors.initials: RW
authors.lastname: Coleman
authors.forename: S W
authors.initials: SW
authors.lastname: Tu
authors.forename: R D
authors.initials: RD
authors.lastname: Shankar
authors.forename: M
authors.initials: M
authors.lastname: O'Connor
authors.forename: S
authors.initials: S
authors.lastname: Martins
authors.forename: S
authors.initials: S
authors.lastname: Martins
authors.forename: A
authors.initials: A
authors.lastname: Advani
authors.forename: M A
authors.initials: MA
authors.lastname: Musen
mesh_terms: D001185:Artificial Intelligence; D020000:Decision Support Systems, Clinical; D004360:Drug Therapy, Computer-Assisted / Q000592:standards*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D016347:Medical Records Systems, Computerized; D008508:Medication Errors / Q000517:prevention & control*; D017410:Practice Guidelines as Topic / Q000592:standards*; D017010:Reminder Systems; D017751:Safety Management