title: Evaluation of real-time clinical decision support systems for platelet and cryoprecipitate orders.
abstract: OBJECTIVE
  To evaluate cryoprecipitate and platelet ordering practices after the implementation of real-time clinical decision support systems (CDSSs) in a computerized physician order entry (CPOE) system.
  
  
  METHODS
  Uniform platelet and cryoprecipitate transfusion thresholds were implemented at 11 hospitals in a regional health care system with a common CPOE system. Over 6 months, a variety of information was collected on the ordering physicians and the number of alerts generated by the CDSSs when these products were ordered outside of the institutional guidelines.
  
  
  RESULTS
  There were 1,889 orders for platelets and 152 orders for cryoprecipitate placed in 6 months. Of these, 1,102 (58.3%) platelet and 74 (48.7%) cryoprecipitate orders triggered an alert. The proportion of orders canceled after an alert was generated ranged from 13.5% to 17.9% for platelets and 0% to 50.0% for cryoprecipitate orders.
  
  
  CONCLUSIONS
  CDSS alerts reduce, but do not eliminate, platelet and cryoprecipitate transfusions that do not meet institutional guidelines.
authors.affiliation: The Institute for Transfusion Medicine, 3636 Blvd of the Allies, Pittsburgh, PA 15213; e-mail: myazer@itxm.org.
authors.forename: Ryan A
authors.initials: RA
authors.lastname: Collins
authors.forename: Darrell J
authors.initials: DJ
authors.lastname: Triulzi
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Waters
authors.forename: Vivek
authors.initials: V
authors.lastname: Reddy
authors.forename: Mark H
authors.initials: MH
authors.lastname: Yazer
mesh_terms: D001803:Blood Transfusion; D020000:Decision Support Systems, Clinical / Q000592:standards*; D019317:Evidence-Based Medicine; D006801:Humans; D050316:Medical Order Entry Systems; D010949:Plasma; D017713:Platelet Transfusion
keywords: Alert; Audit; Computerized order entry; Cryoprecipitate; Patient blood management; Platelet