Development and Feasibility of a Real-Time Clinical Decision Support System for Traumatic Brain Injury Anesthesia Care

Taniga Kiatchai; Ashley A. Colletti; Vivian H. Lyons; Rosemary M. Grant; Monica S. Vavilala; Bala G. Nair

doi:10.4338/ACI-2016-10-RA-0164

Applied Clinical Informatics, Table of Contents

Appl Clin Inform 2017; 08(01): 80-96
DOI: 10.4338/ACI-2016-10-RA-0164

Research Article

Schattauer GmbH

Development and Feasibility of a Real-Time Clinical Decision Support System for Traumatic Brain Injury Anesthesia Care

Taniga Kiatchai

¹Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA

²Harborview Injury Prevention and Research Center, Seattle, WA

,

Ashley A. Colletti

¹Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA

,

Vivian H. Lyons

²Harborview Injury Prevention and Research Center, Seattle, WA

³Department of Epidemiology, University of Washington, Seattle, WA

,

Rosemary M. Grant

⁴Clinical Education, Harborview Medical Center, Seattle, WA

,

Monica S. Vavilala

¹Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA

²Harborview Injury Prevention and Research Center, Seattle, WA

⁵Department of Pediatrics, University of Washington, Seattle, WA

⁶Department of Neurological Surgery and Global Health Medicine, University of Washington, Seattle, WA

,

Bala G. Nair

¹Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA

²Harborview Injury Prevention and Research Center, Seattle, WA

› Author Affiliations

Abstract

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Keywords

Surgical and anesthesia information systems - clinical decision support - alerting

References

References
1 Vavilala MS, Kernic MA, Wang J, Kannan N, Mink RB, Wainwright MS. et. al. Acute care clinical indicators associated with discharge outcomes in children with severe traumatic brain injury. Crit Care Med 2014; 42 (Suppl. 10) 2258-2266.
2 Epstein RH, Dexter F, Patel N. Influencing anesthesia provider behavior using Anesthesia Information Management System data for near real-time alerts and post hoc reports. Anesth Analg 2015; 121 (Suppl. 03) 678-692.
3 Nair BG, Horibe M, Newman SF, Wu WY, Peterson GN, Schwid HA. Anesthesia information management system-based near real-time decision support to manage intraoperative hypotension and hypertension. Anesth Analg 2014; 118 (Suppl. 01) 206-214.
4 Nair BG, Horibe M, Newman SF, Wu WY, Schwid HA. Near real-time notification of gaps in cuff blood pressure recordings for improved patient monitoring. J Clin Monit Comput 2013; 27 (Suppl. 03) 265-271.
5 Nair BG, Newman SF, Peterson GN, Schwid HA. Smart Anesthesia Manager™ (SAM) –a real-time decision support system for anesthesia care during surgery. IEEE Trans Biomed Eng 2013; 60 (Suppl. 01) 207-210.
6 Blum JM, Stentz MJ, Maile MD, Jewell E, Raghavendran K, Engoren M. et. al. Automated alerting and recommendations for the management of patients with preexisting hypoxia and potential acute lung injury: a pilot study. Anesthesiology 2013; 119 (Suppl. 02) 295-302.
7 Nair BG, Peterson GN, Newman SF, Wu WY, Kolios-Morris V, Schwid HA. Improving documentation of a beta-blocker quality measure through an anesthesia information management system and real-time notification of documentation errors. Jt Comm J Qual Saf 2012; 38 (Suppl. 06) 283-288.
8 Nair BG, Newman SF, Peterson GN, Schwid HA. Automated electronic reminders to improve redosing of antibiotics during surgical cases: comparison of two approaches. Surg Infect 2011; 12 (Suppl. 01) 57-63.
9 Chau A, Ehrenfeld JM. Using real-time clinical decision support to improve performance on perioperative quality and process measures. Anesthesiol Clin 2011; 29 (Suppl. 01) 57-69.
10 Ehrenfeld JM, Epstein RH, Bader S, Kheterpal S, Sandberg WS. Automatic notifications mediated by anesthesia information management systems reduce the frequency of prolonged gaps in blood pressure documentation. Anesth Analg 2011; 113 (Suppl. 02) 356-363.
11 Wanderer JP, Sandberg WS, Ehrenfeld JM. Real-time alerts and reminders using information systems. Anesthesiol Clin 2011; 29 (Suppl. 03) 389-396.
12 Schwann NM, Bretz KA, Eid S, Burger T, Fry D, Ackler F. et. al. Point-of-care electronic prompts: an effective means of increasing compliance, demonstrating quality, and improving outcome. Anesth Analg 2011; 113 (Suppl. 04) 869-876.
13 Nair BG, Newman SF, Peterson GN, Wu WY, Schwid HA. Feedback mechanisms including real-time electronic alerts to achieve near 100% timely prophylactic antibiotic administration in surgical cases. Anesth Analg 2010; 111 (Suppl. 05) 1293-1300.
14 Kochanek PM, Carney N, Adelson PD, Ashwal S, Bell MJ, Bratton S. et. al. Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents-second edition. Pediatr Crit Care Med 2012; 13 (Suppl. 01) S1-S82.
15 Gary K, Enquobahrie A, Ibanez L, Cheng P, Yaniv Z, Cleary K. et. al. Agile methods for open source safety-critical software. Softw Pract Exp 2011; 41 (Suppl. 09) 945-962.
16 Kane DW, Hohman MM, Cerami EG, McCormick MW, Kuhlmman KF, Byrd JA. Agile methods in biomedical software development: a multi-site experience report. BMC Bioinformatics 2006; 7: 273.
17 Kaplan B. Evaluating informatics applications--clinical decision support systems literature review. Int J Med Inform 2001; 64 (Suppl. 01) 15-37.
18 Sailors RM, East TD, Wallce CJ, Carlson DA, Franklin MA, Heermann LK. et al. Testing and validation of computerized decision support systems. Proc AMIA Annu Fall Symp 1996; 234-238.
19 Hardcastle N, Benzon HA, Vavilala MS. Update on the 2012 guidelines for the management of pediatric traumatic brain injury –information for the anesthesiologist. Paediatr Anaesth 2014; 24 (Suppl. 07) 703-710.
20 Sandberg WS, Sandberg EH, Seim AR, Anupama S, Ehrenfeld JM, Spring SF. et. al. Real-time checking of electronic anesthesia records for documentation errors and automatically text messaging clinicians improves quality of documentation. Anesth Analg 2008; 106 (Suppl. 01) 192-201.
21 Kheterpal S, Gupta R, Blum JM, Tremper KK, O’Reilly M, Kazanjian PE. Electronic reminders improve procedure documentation compliance and professional fee reimbursement. Anesth Analg 2008; 104 (Suppl. 03) 592-597.
22 Sittig DF, Krall MA, Dykstra RH, Russell A, Chin HL. A survey of factors affecting clinician acceptance of clinical decision support. BMC Med Inform Decis Mak 2006; 6: 6.
23 Nair BG, Schwid HA. Don‘t blame the messenger. Anesth Analg 2015; 121 (Suppl. 06) 1409-1411.
24 Epstein RH, Dexter F, Ehrenfeld JM, Sandberg WS. Implications of event entry latency on anesthesia information management decision support systems. Anesth Analg 2009; 108: 941-947.
25 Takla G, Petre JH, Doyle DJ, Horibe M, Gopakumaran B. The problem of artifacts in patient monitor data during surgery: a clinical and methodological review. Anesth Analg 2006; 103 (Suppl. 05) 1196-1204.