<commit_before>---
title: "Notes for IDWeek 2016 Day 2"
category: Medicine
tags:
    - Infectious Disease
    - Antimicrobial Stewardship
---

Starting here at 7am today... here's my live(ish) notes for the day.

## Maximizing the Electronic Health Record and Clinical Decision Support Systems for Antimicrobial Stewardship ##

- Stewardship teams are supposed to have IT staff on them! who kneww
- Clinical decision support = "Any electronic tool that reduces the cognitive burden of patient care in an electronic health record"
- _read Bates DW et al 2003 - ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality"_
	- little things can make a big difference; doesn't have to involve complicated decisions and algorithms
	- Make it easy to do the right thing & make it harder to do the wrong thing
- So far a lot of suggestions are around CPOE based solutions, things to keep in mind for *someday*
	- eg remove urine culture from urinalysis "quick menu" entry
	- build sets for indication based abx
		- looks like CPOE leave lots of spots where MD can make an error when ordering a med
		- eg "cipro for simple cystitis" defaults to a preset dose and duration for the right dosage form
		- don't overbuild<commit_msg>Idweek day 2 upload<commit_after>---
title: "Notes for IDWeek 2016 Day 2"
category: Medicine
tags:
    - Infectious Disease
    - Antimicrobial Stewardship
---

Starting here at 7am today... here's my live(ish) notes for the day.

## Maximizing the Electronic Health Record and Clinical Decision Support Systems for Antimicrobial Stewardship ##

- Stewardship teams are supposed to have IT staff on them! who kneww
- Clinical decision support = "Any electronic tool that reduces the cognitive burden of patient care in an electronic health record"
- _read Bates DW et al 2003 - ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality"_
	- little things can make a big difference; doesn't have to involve complicated decisions and algorithms
	- Make it easy to do the right thing & make it harder to do the wrong thing
- So far a lot of suggestions are around CPOE based solutions, things to keep in mind for *someday*
	- eg remove urine culture from urinalysis "quick menu" entry
	- build sets for indication based abx
		- looks like CPOE leave lots of spots where MD can make an error when ordering a med
		- eg "cipro for simple cystitis" defaults to a preset dose and duration for the right dosage form
		- don't overbuild
	- hyperlink to dosing guidelines for complicated drugs (vanco) while ordering
	- you could also build in mandatory ID consults for restricted drugs! CPOE looks great
	- can build in shock box sepsis set right in there with the pathways and whatnot (can do things like have it bypass certain prompts and make sure it's all instantly set as STAT)
- most important factor found in interruptive drug-drug alerts was actually the aesthetic display of the alert
- follow up alerts: can be collected and sent straight to ASP pharmacist. 
	- eg: presumptive pseudomonas found on culture, no abx ordered currently that actually cover it

## Maximizing Electronic Health Record and Clinical Decision Support Systems in Community Hospitals ##

- some CDSS can diagnose adverse drug reactions
- high maintenance associated with building your own CDSS; if you are not keeping them up to date, they get out of usefulness very quickly (for recommendation based ones)
- add indication as as a required element for ordering abx in CPOE
- IV/PO alert: if pt has been given another non PRN PO med, and is ordered an IV abx, will show an alert (suppressed with certain examples)
	- also has pharmacist alerts for drugs that have PO stepdown medical directives for pharmacists
{'fraction_non_alphanumeric': 0.03927729772191673, 'fraction_numerical': 0.0054988216810683424, 'mean_word_length': 4.1001335113484645, 'pattern_counts': {'":': 0, '<': 3, '<?xml version=': 0, '>': 3, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
{'dir': 'git-commits-cleaned', 'id': '3289558', 'n_tokens_mistral': 996, 'n_tokens_neox': 899, 'n_words': 584}