Table 5 Knowledge management

Balas 1996

N = 100

Computerized information services in different settings. A. provider prompt, B. provider feedback, C. computerized medical record, D. assisted treatment planning, E. computerized patient education.

Improved test ordering/prevention in A (PSI 14/16 = 88%), B (PSI 7/9 = 78%), and C (PSI 6/8 = 75%). Improved drug prescription in D (PSI 10/12 = 83%). Improved patient knowledge in E (PSI 8/9 = 89%).

Balas 2004

N = 40

Computerized knowledge management in diabetes care. A. provider prompt, B. home glucose records

Improved guideline compliance in A (PSI 6/8 = 75%). Improved glycated hemoglobin (SMD -0.14 mmol/L, S) and blood glucose (SMD -0.33 mmol/L, S) in B.

Currell 1999

N = 8

Nursing record systems

No change in: patient care, patient outcomes. Some administrative benefits.

Kaushal 2003

N = 12

Physician order entry and clinical decision support systems

Physician order entry: decrease in serious medication error (PSI 2/5 = 40%), improved in collollary orders (PSI 1/5 = 20%), improved prescribing behaviors (PSI 100%), improved nephrotoxic drug dose and frequency (PSI 1/5 = 20%). Decision support: improved antibiotic-associated medication errors and adverse drug events (PSI 3/7 = 43%), improvement in theophylinne-associated medication errors (PSI 1/7 = 14%).

Mitchell 2001

N = 61

Computer systems in primary care

Increased consultation length (SMD range 48–130 seconds). Improved immunization rates (ARR range 8–34%). Reduced test ordering (ARR range 6–75%). Improved patient outcomes (PSI 17/89 = 19%).

Walton 1999

N = 15

Computerized decision support on medication prescribing

Blood concentration of drug (AES 0.69, S), time to reach therapeutic concentration (AES – 0.44, S), patient outcomes (PSI5/6 = 83%), cost savings (PSI 2/2 = 100%)