Effectiveness of computerized decision support systems linked to electronic health records: A systematic review and meta-analysis

L. Moja, K.H. Kwag, T. Lytras, L. Bertizzolo, L. Brandt, V. Pecoraro, G. Rigon, A. Vaona, F. Ruggiero, M. Mangia, A. Iorio, I. Kunnamo and S. Bonovas

American Journal of Public Health, 2014, vol. 104, issue 12, e12-e22

Abstract: We systematically reviewed randomized controlled trials (RCTs) assessing the effectiveness ofcomputerized decision support systems (CDSSs) featuring rule- or algorithm-based software integrated with electronic health records (EHRs) and evidence-based knowledge. We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Abstracts of Reviews of Effects. Information on system design, capabilities, acquisition, implementation context, and effects on mortality, morbidity, and economic outcomes were extracted. Twenty-eight RCTs were included. CDSS use did not affect mortality (16 trials, 37395 patients; 2282 deaths; risk ratio [RR] = 0.96; 95%confidence interval [CI] = 0.85, 1.08; I2 = 41%).Astatistically significant effect was evident in the prevention ofmorbidity, any disease (9 RCTs; 13868 patients;RR = 0.82; 95% CI = 0.68, 0.99; I2 = 64%), but selectiveoutcomereporting or publication bias cannot be excluded. We observed differences for costs and health service utilization, although these were often small in magnitude. Across clinical settings, new generation CDSSs integrated with EHRs do not affect mortality and might moderately improvemorbidity outcomes. © 2013 American Public Health Association.

Keywords: algorithm; computer program; decision support system; electronic medical record; health care quality; human; meta analysis; mortality; randomized controlled trial (topic); trends, Algorithms; Decision Support Techniques; Electronic Health Records; Humans; Mortality; Quality Assurance, Health Care; Randomized Controlled Trials as Topic; Software (search for similar items in EconPapers)
Date: 2014
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2014.302164_0

DOI: 10.2105/AJPH.2014.302164

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