Recommendations for the safe, effective use of adaptive CDS in the US healthcare system: an AMIA position paper

Author:

Petersen Carolyn1ORCID,Smith Jeffery2,Freimuth Robert R3,Goodman Kenneth W4ORCID,Jackson Gretchen Purcell56,Kannry Joseph7,Liu Hongfang8,Madhavan Subha9,Sittig Dean F10ORCID,Wright Adam11

Affiliation:

1. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA

2. The Office of the National Coordinator for Health Information Technology, Washington, DC, USA

3. Division of Digital Health Sciences, Center for Individualized Medicine, Mayo Clinic, Rochester, Minnesota, USA

4. Institute for Bioethics and Health Policy, University of Miami Miller School of Medicine, Miami, Florida, USA

5. IBM Watson Health, Cambridge, Massachusetts, USA

6. Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA

7. Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, New York, New York, USA

8. Division of Digital Health Sciences, Mayo Clinic, Rochester, Minnesota, USA

9. Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Innovation Center for Biomedical Informatics, Georgetown University Medical Center, Washington, DC, USA

10. School of Biomedical Informatics, The University of Texas Health Science Center at Houston, UT-Memorial Hermann Center for Healthcare Quality & Safety, Houston, Texas, USA

11. Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA

Abstract

Abstract The development and implementation of clinical decision support (CDS) that trains itself and adapts its algorithms based on new data—here referred to as Adaptive CDS—present unique challenges and considerations. Although Adaptive CDS represents an expected progression from earlier work, the activities needed to appropriately manage and support the establishment and evolution of Adaptive CDS require new, coordinated initiatives and oversight that do not currently exist. In this AMIA position paper, the authors describe current and emerging challenges to the safe use of Adaptive CDS and lay out recommendations for the effective management and monitoring of Adaptive CDS.

Publisher

Oxford University Press (OUP)

Subject

Health Informatics

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