A Process Analysis Approach to Evaluating A Clinical Decision Support System: THE AVIATOR Model

Author: Sirajuddin Anwar, M.B.B.S, M.S.

Primary Advisor: M. Sriram Iyengar, PhD (co-author)

Committee Members: Robert Murphy, M.D (co-author); Daniel R Brown, RPh (co-author); Jiajie Zhang, PhD (co-author)

Masters thesis, The University of Texas School of Health Information Sciences at Houston.

We evaluated a computerized clinical decision support system (CDSS) used by the pharmacy department of a multi facility healthcare system with nine acute care hospitals. This evaluation was timely since this CDSS was to be integrated into a new computerized physician order entry (CPOE) implementation. We developed our own evaluation criteria called the AVIATOR model which consists of analyses of several components of the healthcare system and the application of these findings to all components of the CDSS. The AVIATOR model was deployed to identify drugs that were ordered in high volume and the drugs that were commonly implicated in clinical adverse events. Analysis of data from components of the CDSS reveal that there was a high volume of alerts fired and that a vast majority of these alerts made no changes to the therapies that were initially administered. These alerts created a constant interruption to the pharmacists’ workflow. We made several recommendations to reduce the number of alerts fired and improve their value in therapeutic interventions. The AVIATOR model provided valuable insights into the operation of a complex computerized CDSS, and its impact on health care delivery.