Table 8.

Encountered issues and resolution steps related to automatic detection of unwanted clinical events and generation of guidance reminders

Encountered Issue	Resolution
Delayed detection of hypotension events.	CDS sampling of AIMS database increased to every 1 minute from every 6 minutes (Phase 1)
AIMS interface to patient monitor updated. Errors in interface configuration resulted in oversampling of data and out of memory CDS software errors	AIMS interface corrected. Safeguards in CDS program to prevent processing of over sampled cases (Phase 1)
New anesthesia machines introduced resulting in unanticipated changes in data format in the AIMS interface to these machines	Updated CDS software to accommodate new data format (Phase 1 & 2)
Changes in laboratory interface resulting in missed identification of ABG results	CDS software corrected to accommodate laboratory interface changes (Phase 1)
Decision logic errors in CDS system in processing multichannel temperature values.	Decision rules corrected in CDS system to detect hypothermia and hyperthermia if temperature values are acquired through any channel on the patient monitor. (Phase 1)
Artifacts in blood pressure and end tidal CO2 measurements resulting in false alerts	Boundary and median filters programmed in CDS to minimize the effect of artifacts. (Phase 2)
Change in patient age unit definition in the registration interface to AIMS resulting in misidentification of age less than 1 year	CDS software corrected to handle new age unit definitions (Phase 2)