Critical Care Decision Support Systems

It is not enough to merely manage medical information. It is difficult to justify the cost of hospital information systems (HIS) or intensive care unit (ICU) patient data management systems (PDMS) on this basis alone. The real benefit of an integrated HIS or PDMS is in decision support. We recently went to the bedside of a critically ill patient and counted the current information categories (not repeated measures) that were reviewed for physician decision making. The total was in excess of 236! Dr. Eddy summarized it best: “It is simply unrealistic to think that individuals can synthesize in their head scores of pieces of evidence, accurately estimate the outcomes of different options, and accurately judge the desirability of those outcomes for patients…. All confirm what would be expected from common sense: The complexity of modern medicine exceeds the inherent limitations of the unaided human mind.” Although there are a variety of HIS and ICU PDMS systems available there are few that provide ICU decision support.