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Walter Costa MB, Wernsdorfer M, Kehrer A, Voigt M, Cundius C, Federbusch M, Eckelt F, Remmler J, Schmidt M, Pehnke S, Gärtner C, Wehner M, Isermann B, Richter H, Telle J, Kaiser T. The Clinical Decision Support System AMPEL for Laboratory Diagnostics: Implementation and Technical Evaluation. JMIR Med Inform 2021; 9:e20407. [PMID: 34081013 PMCID: PMC8212627 DOI: 10.2196/20407] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/28/2020] [Accepted: 11/20/2020] [Indexed: 12/21/2022] Open
Abstract
Background Laboratory results are of central importance for clinical decision making. The time span between availability and review of results by clinicians is crucial to patient care. Clinical decision support systems (CDSS) are computational tools that can identify critical values automatically and help decrease treatment delay. Objective With this work, we aimed to implement and evaluate a CDSS that supports health care professionals and improves patient safety. In addition to our experiences, we also describe its main components in a general manner to make it applicable to a wide range of medical institutions and to empower colleagues to implement a similar system in their facilities. Methods Technical requirements must be taken into account before implementing a CDSS that performs laboratory diagnostics (labCDSS). These can be planned within the functional components of a reactive software agent, a computational framework for such a CDSS. Results We present AMPEL (Analysis and Reporting System for the Improvement of Patient Safety through Real-Time Integration of Laboratory Findings), a labCDSS that notifies health care professionals if a life-threatening medical condition is detected. We developed and implemented AMPEL at a university hospital and regional hospitals in Germany (University of Leipzig Medical Center and the Muldental Clinics in Grimma and Wurzen). It currently runs 5 different algorithms in parallel: hypokalemia, hypercalcemia, hyponatremia, hyperlactatemia, and acute kidney injury. Conclusions AMPEL enables continuous surveillance of patients. The system is constantly being evaluated and extended and has the capacity for many more algorithms. We hope to encourage colleagues from other institutions to design and implement similar CDSS using the theory, specifications, and experiences described in this work.
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Affiliation(s)
- Maria Beatriz Walter Costa
- Institute of Laboratory Medicine, Clinical Chemistry und Molecular Diagnostics, University of Leipzig Medical Center, Leipzig, Germany.,Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Mark Wernsdorfer
- Institute of Laboratory Medicine, Clinical Chemistry und Molecular Diagnostics, University of Leipzig Medical Center, Leipzig, Germany.,Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | | | - Markus Voigt
- Information Management, University of Leipzig Medical Center, Leipzig, Germany
| | - Carina Cundius
- Information Management, University of Leipzig Medical Center, Leipzig, Germany
| | - Martin Federbusch
- Institute of Laboratory Medicine, Clinical Chemistry und Molecular Diagnostics, University of Leipzig Medical Center, Leipzig, Germany
| | - Felix Eckelt
- Institute of Laboratory Medicine, Clinical Chemistry und Molecular Diagnostics, University of Leipzig Medical Center, Leipzig, Germany
| | - Johannes Remmler
- Institute of Laboratory Medicine, Clinical Chemistry und Molecular Diagnostics, University of Leipzig Medical Center, Leipzig, Germany
| | - Maria Schmidt
- Institute of Laboratory Medicine, Clinical Chemistry und Molecular Diagnostics, University of Leipzig Medical Center, Leipzig, Germany.,Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Sarah Pehnke
- Institute of Laboratory Medicine, Clinical Chemistry und Molecular Diagnostics, University of Leipzig Medical Center, Leipzig, Germany
| | - Christiane Gärtner
- Institute of Laboratory Medicine, Clinical Chemistry und Molecular Diagnostics, University of Leipzig Medical Center, Leipzig, Germany.,Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Markus Wehner
- Muldental Clinics GmbH Non-Profit Company, Hospital Grimma and Wurzen, Grimma, Germany
| | - Berend Isermann
- Institute of Laboratory Medicine, Clinical Chemistry und Molecular Diagnostics, University of Leipzig Medical Center, Leipzig, Germany
| | - Heike Richter
- Muldental Clinics GmbH Non-Profit Company, Hospital Grimma and Wurzen, Grimma, Germany
| | | | - Thorsten Kaiser
- Institute of Laboratory Medicine, Clinical Chemistry und Molecular Diagnostics, University of Leipzig Medical Center, Leipzig, Germany
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