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Accepted for/Published in: JMIR Medical Informatics

Date Submitted: Jun 15, 2020
Date Accepted: Nov 20, 2020

The final, peer-reviewed published version of this preprint can be found here:

The Clinical Decision Support System AMPEL for Laboratory Diagnostics: Implementation and Technical Evaluation

Walter Costa MB, Wernsdorfer M, Kehrer A, Voigt M, Cundius C, Federbusch M, Eckelt F, Remmler J, Schmidt M, Pehnke S, Gärtner C, Wehner M, Isermann B, Richter H, Telle J, Kaiser T

The Clinical Decision Support System AMPEL for Laboratory Diagnostics: Implementation and Technical Evaluation

JMIR Med Inform 2021;9(6):e20407

DOI: 10.2196/20407

PMID: 34081013

PMCID: 8212627

The Clinical Decision Support System AMPEL for Laboratory Diagnostics: Implementation and Technical Evaluation

  • Maria Beatriz Walter Costa; 
  • Mark Wernsdorfer; 
  • Alexander Kehrer; 
  • Markus Voigt; 
  • Carina Cundius; 
  • Martin Federbusch; 
  • Felix Eckelt; 
  • Johannes Remmler; 
  • Maria Schmidt; 
  • Sarah Pehnke; 
  • Christiane Gärtner; 
  • Markus Wehner; 
  • Berend Isermann; 
  • Heike Richter; 
  • Jörg Telle; 
  • Thorsten Kaiser

ABSTRACT

Background:

Laboratory results are of central importance for clinical decision making. The time span between availability and acknowledgment of results by physicians making clinical decisions is critical for patient care. Clinical Decision Support Systems (CDSS) could help to decrease this lag-time and improve patient safety.

Objective:

With this work we aim to build a reliable system that is applicable to a wide range of medical institutions, supports health care professionals and improves patient safety.

Methods:

AMPEL is a reactive agent that was implemented in the SAP Data/Business Warehouse. It was incorporated within a complex system architecture, which includes SAP as the Clinical Information System (CIS), LabCentre as the Laboratory Information System (LIS) and three communication servers.

Results:

We present a system architecture and dataflow required to build a CDSS that monitors laboratory results and alarms health care professionals if critical values are detected. We developed and implemented the CDSS AMPEL for patient monitoring at a university hospital and a regional hospital in Germany (Universitätsmedizin Leipzig (UML) and the Muldental Clinics in Grimma and Wurzen): https://www.ampel.care/en/.

Conclusions:

The first results in clinical application showed the medical benefit of AMPEL , which enables continuous surveillance of patients. It currently runs five different algorithms in parallel: hypokalemia, hypercalcemia, hyponatremia, lactate and acute kidney injury. The system is being continuously extended and has the capacity for many more algorithms. With this technical evaluation we demonstrate the solid computational basis for AMPEL. Clinical Trial: Does not apply.


 Citation

Please cite as:

Walter Costa MB, Wernsdorfer M, Kehrer A, Voigt M, Cundius C, Federbusch M, Eckelt F, Remmler J, Schmidt M, Pehnke S, Gärtner C, Wehner M, Isermann B, Richter H, Telle J, Kaiser T

The Clinical Decision Support System AMPEL for Laboratory Diagnostics: Implementation and Technical Evaluation

JMIR Med Inform 2021;9(6):e20407

DOI: 10.2196/20407

PMID: 34081013

PMCID: 8212627

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