Clinical validity of alerts generated by the CareEngine Claims-Driven Decision Support Engine.
Clinical decision support based on administrative data is an important "real-world" challenge. At an academic medical center, we reviewed medical charts to assess the accuracy of 182 clinical alerts generated from administrative claims, pharmacy data, and lab results by a computerized clinical decision support (CDS) system. Overall accuracy was 82%. The primary factor affecting alert accuracy was availability of complete data. Claims-driven CDS may be sufficiently accurate to be a valuable adjunct to quality improvement.
Wei
Henry G
HG
Weill-Cornell Medical College, ActiveHealth Management, New York, NY, USA.
Rosenberg
Stephen
S
Shnaiden
Tatiana
T
Jacques
Jeffrey
J
Steinberg
Gregory
G
Reisman
Lonny
L
D020000:Decision Support Systems, Clinical / Q000706:statistics & numerical data*; D007345:Insurance Claim Review / Q000706:statistics & numerical data*; D019300:Medical Errors / Q000517:prevention & control* / Q000706:statistics & numerical data*; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D009518:New York; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity