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KMID : 0869620100270020132
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Journal of Korean Society of Hospital Pharmacists
2010 Volume.27 No. 2 p.132 ~ p.138
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Evaluation of Clinical Decision Supporting System as part of the Order Communication System
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Seo Ji-Yeong
Lee Eun-Jae
Lee Ja-Gyun
Cho Kyung-Hee
Ham Jung-Yeon
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Abstract
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Objectives : We evaluated the effectiveness of Clinical Decision Supporting System (CDSS) which Kangbuk Samsung Medical Center(KBSMC) has developed.
Methods: The prescriptions for hospitalized patients during the study period were reviewed before and after the application of two typical CDSS programs interworking with Order Communication System(OCS). The effectiveness of programs which is not applicable to medicinal powder was evaluated by assessing the number of prescriptions of the alternative medicines, Lansoprazole Orally Disintegrating tablets(ODT) and Valproic acid syrup. In the case of the program assessing narcotic drug amount level, the number of prescription was checked for Pethidine 25mg at the specification of 50mg. For the study, the prescription review book of the year 2009 was investigated.
Results: After applying the program, Valproic acid usage was increased 6.6 times in terms of the prescription amount: 14,238ml and 82,542ml of year 2006 and 2008, respectively, and 105,122ml at 2009(Annual average 14,238 ml vs 93,832 ml). Annual amount of Lansoprazole prescription increased 7 times after application of the program: 3,140 and 4,189 tablets for year 2008 and 2009, respectively, compared to 524 tablets for year 2006 when the program had not been applied(Annual average 3,664 tablets vs 524 tablets). The number of cases in which Pethidine 50mg was leftover after prescription has decreased after the program application in December 2009: 92 cases for Aug, 57 cases for Sep, 65 cases for Oct, and 71 cases for Nov in the year of 2009 compared to 48 and 9 cases for Dec 2009 and Jan 2010, respectively, with no occur from February to March(Monthly average 71 cases vs 14 cases). The analysis of 2009 prescription review book has shown that simple OCS operational mistakes were mainly found for outpatient prescriptions. In case of inpatient, however, many mistakes were caused by incomplete understanding of the hospital system and prescription drugs as well
as the operational errors in OCS.
Conclusion: The CDSS programs evaluated in this study were all effective. The prescription of medicines which is not applicable to medicinal powder and the remaining amount of narcotic drug occurred at reduced level. Drug-related CDSS is necessary for all medical institutions. However, the indiscriminate development of the program could drop clinician’s acceptance rate and interfere with medical care. Therefore, the information provided must be clinically meaningful and should be constantly updated.
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KEYWORD
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CDSS(Clinical Decision Support System), OCS(Order Communication System), Medicinal powder, prescription review book
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