The effectiveness of computerized clinical guidelines in the process of care: a systematic review.
BACKGROUND
Clinical practice guidelines have been developed aiming to improve the quality of care. The implementation of the computerized clinical guidelines (CCG) has been supported by the development of computerized clinical decision support systems.This systematic review assesses the impact of CCG on the process of care compared with non-computerized clinical guidelines.


METHODS
Specific features of CCG were studied through an extensive search of scientific literature, querying electronic databases: Pubmed/Medline, Embase and Cochrane Controlled Trials Register. A multivariable logistic regression was carried out to evaluate the association of CCG's features with positive effect on the process of care.


RESULTS
Forty-five articles were selected. The logistic model showed that Automatic provision of recommendation in electronic version as part of clinician workflow (Odds Ratio [OR]= 17.5; 95% confidence interval [CI]: 1.6-193.7) and Publication Year (OR = 6.7; 95%CI: 1.3-34.3) were statistically significant predictors.


CONCLUSIONS
From the research that has been carried out, we can conclude that after implementation of CCG significant improvements in process of care are shown. Our findings also suggest clinicians, managers and other health care decision makers which features of CCG might improve the structure of computerized system.
Damiani
Gianfranco
G
Department of Public Health-Università Cattolica Sacro Cuore-Rome, Rome, Italy. gdamiani@rm.unicatt.it
Pinnarelli
Luigi
L
Colosimo
Simona C
SC
Almiento
Roberta
R
Sicuro
Lorella
L
Galasso
Rocco
R
Sommella
Lorenzo
L
Ricciardi
Walter
W
D020000:Decision Support Systems, Clinical / Q000592:standards*; D006801:Humans; D017410:Practice Guidelines as Topic; D017064:Process Assessment, Health Care; D012919:Social Behavior