identification and prioritization of clinical decision support functionalities built within a computerized provider order entry system

Background: clinical decision support (cds) functionalities in computerized provider order entry system (cpoe) need to be identifiedby the institutional healthcare providers in developing countries. in this regard, cds functionalities should be a priority forthe execution in cpoe.objectives: thus, our study was done to identify and prioritize the cds functionalities in cpoe.methods: a two-round modified delphi process was used. firstly, a systematic search was conducted in electronic databases fromthe date of database inception to february 2019 for identifying cds functionalities integrated into cpoe. studies were retrievedfrom databases, including pubmed, embase, proquest, scopus, web of science, cochrane, science direct, acm digital library, andieee xplore digital library. secondly, the modified delphi method was carried out in 2019 to provide contextual priorities regardingcds functionalities in cpoe in two iterative rounds. a total of 12 experts working in the three intensive care units (icus) with morethan three years of experience withhomegrowncpoe in shiraz nemazee teaching hospital, including two clinical pharmacists, twohealth information management faculty member, four cases with critical care fellowship, and four critical care experts participatedin the study. the 66.6% agreement was considered as the consensus level. spss software version 24 was used for statistical analysis.results: totally, 327 studies, which met eligibility criteria were found. a number of 60 potential cds functionalities in cpoe wereidentified from eligible studies. also, 13 out of 60 cds functionalities reached high priority consensus after 2 iterative delphi rounds,including drug-allergy checking (83.3%), basic dosing guidance (75%), single dosing checking (66.7%), duplicate therapy checking(66.7%), drug-pregnancy alerts (75%), time-based alerts (66.7%), alert for deep vein thrombosis prophylaxis (66.7%), alerts for duplicatemedication order checking (66.7%), drug-drug interaction checking (75%), intelligent dosing guidance based on the patients’ characteristics(66.7%), renal-drug problems checking (83.3%), drug-disease interaction checking (66.7%), and displaying medication/testcost (75%).conclusions: our study identified high-priority cds functionalities to be considered in the cpoe system from the viewpoint of multidisciplinaryexperts, especially in iran. results of this study may be beneficial to plan, design, and implement cds functionalitiesin cpoe in the icu.