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(Chest. 2000;118:47S-52S.)
© 2000 American College of Chest Physicians

Computer Decision Support Systems*

Thomas H. Payne, MD

* From the VA Puget Sound Health Care System, University of Washington, Seattle, WA.

Correspondence to: Thomas H. Payne, MD, VA Puget Sound Health Care System, 1660 South Columbian Way, Mail Stop S-007-CIM, Seattle, WA 98108; e-mail: tpayne{at}u.washington.edu

Computer decision support systems are computer applications designed to aid clinicians in making diagnostic and therapeutic decisions in patient care. They can simplify access to data needed to make decisions, provide reminders and prompts at the time of a patient encounter, assist in establishing a diagnosis and in entering appropriate orders, and alert clinicians when new patterns in patient data are recognized. Decision support systems that present patient-specific recommendations in a form that can save clinicians time have been shown to be highly effective, sustainable tools for changing clinician behavior. Designing and implementing such systems is challenging because of the computing infrastructure required, the need for patient data in a machine-processible form, and the changes to existing workflow that may result. Despite these difficulties, there is substantial evidence from trials in a wide range of clinical settings that computer decision support systems help clinicians do a better job caring for patients. As computer-based records and order-entry systems become more common, automated decision support systems will be used more broadly.

Key Words: decision support systems, clinical • drug therapy, computer-assisted • hospital information systems • medical informatics • medical records systems, computerized • practice guidelines • therapy, computer-assisted




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