title: A systematic review of near real-time and point-of-care clinical decision support in anesthesia information management systems.
abstract: Anesthesia information management systems (AIMS) are sophisticated hardware and software technology solutions that can provide electronic feedback to anesthesia providers. This feedback can be tailored to provide clinical decision support (CDS) to aid clinicians with patient care processes, documentation compliance, and resource utilization. We conducted a systematic review of peer-reviewed articles on near real-time and point-of-care CDS within AIMS using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Studies were identified by searches of the electronic databases Medline and EMBASE. Two reviewers screened studies based on title, abstract, and full text. Studies that were similar in intervention and desired outcome were grouped into CDS categories. Three reviewers graded the evidence within each category. The final analysis included 25 articles on CDS as implemented within AIMS. CDS categories included perioperative antibiotic prophylaxis, post-operative nausea and vomiting prophylaxis, vital sign monitors and alarms, glucose management, blood pressure management, ventilator management, clinical documentation, and resource utilization. Of these categories, the reviewers graded perioperative antibiotic prophylaxis and clinical documentation as having strong evidence per the peer reviewed literature. There is strong evidence for the inclusion of near real-time and point-of-care CDS in AIMS to enhance compliance with perioperative antibiotic prophylaxis and clinical documentation. Additional research is needed in many other areas of AIMS-based CDS.
authors.affiliation: Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Blvd., Philadelphia, PA, 19104-4399, USA. simpaoa@email.chop.edu.
authors.forename: Allan F
authors.initials: AF
authors.lastname: Simpao
authors.affiliation: Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Blvd., Philadelphia, PA, 19104-4399, USA.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Tan
authors.affiliation: Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Blvd., Philadelphia, PA, 19104-4399, USA.
authors.forename: Arul M
authors.initials: AM
authors.lastname: Lingappan
authors.affiliation: Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Blvd., Philadelphia, PA, 19104-4399, USA.
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Gálvez
authors.affiliation: University of Pennsylvania Biomedical Library, Perelman School of Medicine, University of Pennsylvania, 3610 Hamilton Walk, Philadelphia, PA, 19104-6060, USA.
authors.forename: Sherry E
authors.initials: SE
authors.lastname: Morgan
authors.affiliation: The Permanente Federation and the Oregon Health and Science University, 10040 SW Balmer Circle, Portland, OR, 97219, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Krall
mesh_terms: D000766:Anesthesia, Dental; D000776:Anesthesiology / Q000295:instrumentation* / Q000379:methods; D019072:Antibiotic Prophylaxis; D001786:Blood Glucose / Q000032:analysis; D020000:Decision Support Systems, Clinical / Q000295:instrumentation*; D004282:Documentation; D006801:Humans; D019451:Information Management; D016343:Monitoring, Intraoperative / Q000295:instrumentation* / Q000379:methods; D009325:Nausea / Q000517:prevention & control; D019095:Point-of-Care Systems; D011183:Postoperative Complications; D012984:Software; D055986:Vital Signs
chemical_list: D001786:Blood Glucose
keywords: Clinical decision support systems; Computerized medical records systems; Integrated advanced information management systems