Improving empiric antibiotic selection using computer decision support

• HIT Description: Computerized decision support with artificial intelligence; Electronic health record More info...
  
• Purpose of Study: Evaluate a computerized antibiotic consultant to assist physicians in the selection of appropriate empiric antibiotics.
  
• Years of study: 1990
  
• Study Design: RCT
  
• Outcomes: Impact on health care effectivness/quality, Other outcome
  

• Settings: House staff physicians from a tertiary academic hospital in Salt Lake City, Utah participated in the study.
• Intervention: Ordering antibiotics suggested by the computerized antibiotic consultant was compared to antibiotics ordered by physicians.
• Evaluation Method: Measures of antibiotics selection and timing, and provider satisfaction.
• Description: The hospital used the information system called ÒHELPÓ, which was developed by the institution.
• Quality of Care and Patient Safety Outcome: The antibiotic consultant suggested an antibiotic regimen to which all isolated pathogens were shown to be susceptible for 453 (94%) of 482 culture results, while physicians ordered an antibiotic regimen to which all isolated pathogens were susceptible for 369 culture results (77%) (P .001). The physicians who prescribed antibiotics to which all pathogens were susceptible did so a mean of 21 hours after the culture specimens were collected. Physicians ordered appropriate antibiotics within 12 hours of the culture collection significantly more often when they had use of the antibiotic consultant than during the period before use (P .035).
• Changes in efficiency and productivity: Eighty-eight percent of the physicians stated they would recommend the program to other physicians, 85% said the program improved their antibiotic selection, and 81% said they felt use of the program improved patient care.