{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T11:57:08Z","timestamp":1761393428464},"reference-count":50,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2008,6,28]],"date-time":"2008-06-28T00:00:00Z","timestamp":1214611200000},"content-version":"vor","delay-in-days":819,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2006,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p> <jats:italic>\n            <jats:bold>Background:<\/jats:bold>\n          <\/jats:italic> Clinical practice guidelines and computerized provider order entry (CPOE) have potential for improving clinical care. Questions remain about feasibility and effectiveness of CPOE in the emergency department (ED). However, successful implementations in other settings typically incorporate decision support functions that are lacking in many commercially available ED information systems.<\/jats:p><jats:p> <jats:italic>\n            <jats:bold>Objectives:<\/jats:bold>\n          <\/jats:italic> To compare acute coronary syndrome (ACS) guideline compliance before and after implementation of a locally implemented ACS guideline, first on paper and then in a commercially available ED information system without patient\u2010specific clinical decision support.<\/jats:p><jats:p> <jats:italic>\n            <jats:bold>Methods:<\/jats:bold>\n          <\/jats:italic> Clinical data were abstracted retrospectively on patients seen before and after introduction of paper and, subsequently, CPOE versions of ACS guideline\u2010based order\u2010sets. Order\u2010set use was determined. Risk category assignments were made retrospectively using guideline criteria and compliance with the guideline regarding <jats:italic>\u03b2<\/jats:italic>\u2010blockers, heparin, and aspirin was determined. Association between order\u2010set use and compliance was determined.<\/jats:p><jats:p> <jats:italic>\n            <jats:bold>Results:<\/jats:bold>\n          <\/jats:italic> The authors found increasing use of order\u2010sets over the period of study. However, there was poor association between the order\u2010sets used and risk stratification category. Some association between ED <jats:italic>\u03b2<\/jats:italic>\u2010blocker use and use of CPOE order\u2010sets was found, but there was no improvement in overall compliance with any of the guideline recommendations.<\/jats:p><jats:p> <jats:italic>\n            <jats:bold>Conclusions:<\/jats:bold>\n          <\/jats:italic> Adherence to an ACS guideline did not improve with implementation of a commercial ED information system without provision for patient\u2010specific decision support. This suggests that the lack of patient\u2010specific decision\u2010support functionality in most current ED information system products may hamper progress in the development of effective decision support.<\/jats:p>","DOI":"10.1197\/j.aem.2005.09.015","type":"journal-article","created":{"date-parts":[[2006,3,11]],"date-time":"2006-03-11T02:14:28Z","timestamp":1142043268000},"page":"452-458","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Embedded Guideline Information without Patient Specificity in a Commercial Emergency Department Computerized Order\u2010entry System"],"prefix":"10.1111","volume":"13","author":[{"given":"Phillip V.","family":"Asaro","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy L.","family":"Sheldahl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas M.","family":"Char","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2008,6,28]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.15.1458"},{"key":"e_1_2_1_3_1","first-page":"408","article-title":"Translating guidelines into practice. 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