Monitoring

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Monitoring systems "watch" the clinical database for the storage of particular data items or the passage of a predetermined amount of time. Once such an item is stored in the database, a program is called which "decides" whether the particular data value (or combination of data values) warrants notifying a clinician. Monitoring systems work best on problem areas in which the medical knowledge can be represented in one or more if-then-else type constructs. These systems have met with considerable success in areas as simple as the detection of abnormal laboratory results [Bradshaw, 1989] and adverse drug events [Classen, 1992] or as complicated as ventilator monitoring in ICU patients [Sittig, 1989]. Most clinicians find the "safety net" effect of such systems reassuring and more often than not are happy to comply with the computer's suggestion.


  1. Bradshaw KE, Gardner RM, Pryor TA. Development of a computerized laboratory alerting system. Comput Biomed Res 1989 Dec;22(6):575-87
  2. Classen DC, Pestotnik SL, Evans RS, Burke JP. Computerized surveillance of adverse drug events in hospital patients. JAMA 1991 Nov 27;266(20):2847-51 Published erratum appears in JAMA 1992 Apr 8;267(14):1922
  3. Sittig DF, Pace NL, Gardner RM, Beck E, Morris AH. Implementation of a computerized patient advice system using the HELP clinical information system. Comput Biomed Res 1989 Oct;22(5):474-87