Computerassisted Decision Support

Integration of data from the microbiology laboratory, pharmacy, medical record, and financial databases can assist physicians in decision making in a timely fashion. Antimicrobial susceptibility data, pharmacokinetic information about the individual patient, specific patient factors, and financial data of antimicrobial choices can be presented to the physician at the point of care, in an effort to improve antimicrobial prescribing, cost, and patient outcomes (32).

Antibiotic costs have been significantly reduced using a computer-assisted management program for antibiotics in a small intensive care unit (37). The computer program recommends antibiotic regimens and courses of therapy for individual patients, and provides immediate feedback to the provider at the point-of-care. During a 1-yr intervention period, in 545 patients managed in the intensive care unit, there was a documented improvement in quality of patient care and medication costs when compared to retrospective data. Decreases were noted in medications administered to patients with known allergies, excess drug dosages, antibiotic-susceptibility mismatches, mean number of days of excessive drug dosages, and adverse events caused by antibiotics. In addition, cost of antibiotics was reduced threefold, as were total hospital costs and hospital length of stay. The advantages of the computerized decision support tool were demonstrated in this study, and allowed for more efficient data retrieval. Physicians therefore had more time available to spend on other medical decisions. However, in systems where the use of computer systems is less prevalent, this intervention might be costly and less effective.

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