Adam Wright, PhD
Associate Professor of Medicine, BWH
Associate Professor of Biomedical Informatics, HMS (Secondary)
Blavatnik Institute, Biomedical Informatics
Harvard Medical School

Abstract:
Clinical decision support (CDS) has been shown to improve quality and safety when used effectively.  However, effective CDS is challenging, and users often report poor utility of CDS interventions and alert fatigue and proving that CDS has an impact on clinical outcomes has been difficult.  One particularly insidious issue occurs when CDS malfunctions – in a recent survey, we found that 93% of Chief Medical Information Officers had experienced at least one CDS malfunction, and two-thirds experienced malfunctions at least annually. In this talk, I will present recent research on CDS system reliability and malfunctions, including a taxonomy of malfunction causes, tools for detecting issues with CDS and best practices for avoiding problems.