{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T15:06:08Z","timestamp":1773414368019,"version":"3.50.1"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2017,9,23]],"date-time":"2017-09-23T00:00:00Z","timestamp":1506124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/academic.oup.com\/journals\/pages\/about_us\/legal\/notices"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Many institutions have implemented clinical decision support systems (CDSSs). While CDSS research papers have focused on benefits of these systems, there is a smaller body of literature showing that CDSSs may also produce unintended adverse consequences (UACs). Detailed here are 2 cases of UACs resulting from a CDSS. Both of these cases were related to external systems that fed data into the CDSS. In the first case, lack of knowledge of data categorization in an external pharmacy system produced a UAC; in the second case, the change of a clinical laboratory instrument produced the UAC. CDSSs rely on data from many external systems. These systems are dynamic and may have changes in hardware, software, vendors, or processes. Such changes can affect the accuracy of CDSSs. These cases point to the need for the CDSS team to be familiar with these external systems. This team (manager and alert builders) should include members in specific clinical specialties with deep knowledge of these external systems.<\/jats:p>","DOI":"10.1093\/jamia\/ocx096","type":"journal-article","created":{"date-parts":[[2017,8,22]],"date-time":"2017-08-22T03:12:26Z","timestamp":1503371546000},"page":"564-567","source":"Crossref","is-referenced-by-count":33,"title":["Unintended adverse consequences of a clinical decision support system: two cases"],"prefix":"10.1093","volume":"25","author":[{"given":"Erin G","family":"Stone","sequence":"first","affiliation":[{"name":"Department of Hospital Medicine, Kaiser Permanente, Woodland Hills, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2017,9,23]]},"reference":[{"issue":"1","key":"2020110612224159400_ocx096-B1","doi-asserted-by":"crossref","first-page":"29","DOI":"10.7326\/0003-4819-157-1-201207030-00450","article-title":"Effect of clinical decision-support systems: a systematic review","volume":"157","author":"Bright","year":"2012","journal-title":"Ann Intern Med."},{"key":"2020110612224159400_ocx096-B2","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.ijmedinf.2015.12.017","article-title":"A review of randomized controlled trials of medical record powered clinical decision support system to improve quality of diabetes care","volume":"87","author":"Ali","year":"2016","journal-title":"Int J Med Inf."},{"issue":"6","key":"2020110612224159400_ocx096-B3","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1111\/dme.12087","article-title":"Can computerized clinical decision support systems improve diabetes management? 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