A systematic review of near real-time and point-of-care clinical decision support in anesthesia information management systems
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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.
KeywordsComputerized medical records systems Integrated advanced information management systems Clinical decision support systems
A.F.S., J.M.T., A.M.L., J.A.G., S.E.M., and M.A.K. contributed substantially to the conception and design of this review, drafted the article and revised it critically for important intellectual content, approved of the final version to be published, and agree to be accountable for all aspects of the work thereby ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
This work was supported only by departmental resources.
Compliance with ethical standards
Conflict of interest
Allan F. Simpao is on the associate editorial board for Anesthesiology, a U.S. anesthesia journal. Jorge A. Galvez is on the associate editorial board for Anesthesiology, a U.S. anesthesia journal. Microsoft provided funds for the development for Pedi Crisis, an app that Dr. Galvez developed. All funding was applied to software development costs; Dr. Galvez did not receive monetary compensation or support from Microsoft for the app development. The remaining authors declare that they have no conflict of interest.
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