Real-Time Active Clinical

Decision Support for

Intraoperative Anesthesia
Care
Cejamil Calderon
University of San Diego
HCIN 552: Clinical Documentation
Professor Cynthia Reed
Anesthesia Information
Management System (AIMS) and
the need for CDS
AIMS
● AIMS was created to alleviate
burden of paper charting while
the Anesthesiologist or Nurse
Anesthetist is focus on the
patient and safety
● Automatic recording of patient
monitoring and anesthesia data
to help facilitate clinicians with
intraoperative care.
Real-Time Active CDS
● A Real-Time Active Clinical Decision
Support (CDS) for the AIMS has the
true potential for improving the
quality of care for patients, overall
staff, and patient safety, and
organizational compliance.
● Detect and analyze ongoing clinical
issues and deviations
● Overall goal is for clinician that real-
time remedial actions can be taken;
keeping the patient physiologically
stable
● Real-Time Active CDS will improve
the legibility and accuracy of the
overall anesthesia record by
presenting real time data.
Method of Integration of Real Time
Active CDS for AIMS

● Stand Alone Monitor integrated with AIMS

● Unique visual display of organ systems with a combination of color codes
● Textual description to present alerts.
● The alert will incorporate pop up reminders for active alerts.
https://alertwatch.com/wp-content/demo/awdemo.html
Workflow Analysis for Anesthesia in
the Operating Room
Real Time Active CDS for AIMS
Implementation Timeline
Monitoring and Evaluation of Active
Real Time CDS for AIMS
Components of an Intraoperative CDS System
 Monitoring and Evaluation of
Active Real Time CDS for AIMS
Measuring the effectiveness of a CDS system can be classified into the following categories:

● Performance Measures-Data ● User Acceptance- Unified

latency, artifacts, software defects, consensus, Conducting staff surveys

reliability. ● Improving CDS Systems-

● Outcome Measures- Patient Continuous modifications, upgrades.

outcomes and targeting adherence to Feedback from staff for refinements to

protocols. CDS Strategy and systems features

● Process Measures-Assess ● Alert Fatigue- Monitor provider

Anesthesiologist/CRNA behavior on CDS disregard/distraction of alerts.

effect. Conducting of focus groups to solicit

Questions ?
 References
● AlertWatch. (2020). AlertWatch:OR Interactive Demo. AlertWatch. https://alertwatch.com/wp-content/demo/awdemo.html.

● Editors, M. (2014, February 14). AlertWatch Anesthesia Info System for Actionable Display of Patient Data. Medgadget.

https://www.medgadget.com/2014/02/alertwatch.html.

● Kiatchai, T., Colletti, A., Lyons, V., Grant, R., Vavilala, M., & Nair, B. (2017). Development and Feasibility of a Real-Time Clinical

Decision Support System for Traumatic Brain Injury Anesthesia Care. Applied Clinical Informatics, 26(01), 80–96.

https://doi.org/10.4338/aci-2016-10-ra-0164

● Nair, B. G., Gabel, E., Hofer, I., Schwid, H. A., & Cannesson, M. (2017). Intraoperative Clinical Decision Support for Anesthesia.

Anesthesia & Analgesia, 124(2), 603–617. https://doi.org/10.1213/ane.0000000000001636

● Stevenson, S. S. (2013, April 22). AlertWatch Offers New Way to Monitor Patients in the OR. Xconomy. https://xconomy.com/detroit-

ann-arbor/2013/04/18/alertwatch/.

● Wanderer, J. P., Sandberg, W. S., & Ehrenfeld, J. M. (2011). Real-time alerts and reminders using information systems. Anesthesiology

clinics, 29(3), 389–396. https://doi.org/10.1016/j.anclin.2011.05.003