Implementing a clinical decision support system for glucose control for the intensive cardiac care

Adherence to guidelines and protocols in clinical practice can be difficult to achieve. We describe the implementation of a Clinical Decision Support System (CDSS) for glucose control on the Intensive Cardiac Care Unit (ICCU) of the Erasmus MC. An existing paper protocol for glucose control was used for the CDSS rule set. In the first phase we implemented a proof of concept of a CDSS: a web 2.0 AJAX-driven web screen, which resulted in an improved adherence to the glucose guideline. This paper will reflect on the technical implementations and challenges of our experience with this process. The end product will allow: storage of guidelines in a shareable and uniform matter, presentation of guidelines in a more clear way to physicians, a more flexible platform to maintain guidelines, the ability to adjust guidelines to incorporate changes based on collected evidence from the CDSS and/or literature review, and be able to better review the outcome.

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