Technology has significantly advanced in the last decade within the hospital setting with the development of Electronic Health Records (EHR) and computer physician order entry (CPOE) systems. The CPOE, in particular, has been identified as a potential key action in improving patient safety \cite{Kuperman_2003}. Computer clinical decision support programs exist that complement the EHR and CPOE, which can provide epidemiologic data (e.g., antibiogram), warnings (drug interactions, excess dosages), allergies, or therapy guidelines (drug-bug mismatches) in real-time during order entry or chart review. Such performance capabilities have demonstrated increases in patient safety, cost savings, and decreased time allotted to ASP activities \cite{Kullar_2014,Evans1998}.
As a complement to EHRs, CPOE systems, and decision support software, computer-based surveillance programs have also been developed and implemented in the hospital settings and used specifically in ASPs. These programs have been used to collect data on hospital-acquired infections and adverse drug reactions \cite{Dellit_2007,Evans1986}. Thus, incorporating surveillance programs and CPOE with decision support programs can likely improve patient safety and the ASP by providing real-time data at the point of care, leading to improved clinical decisions and facilitating data collection for antimicrobial targeting or interventions \cite{Dellit_2007}.
Conclusion
The ASP plays a critical role in patient safety. Hospitals that undergo Joint Commission accreditation or participate in Medicare and Medicaid are now required by law to have a formal antimicrobial stewardship program in place comprised of at least an ID physician and clinical pharmacist, but should ideally also include nursing, a microbiologist, infection control and IT personnel. A number of interventions and different program types can make up the ASP, which includes actions from the pharmacy, microbiology, and IT departments. The resources required for implementing the ASP can range from minimal resources to dedicated resources (Table 1); however, once implemented, ASP initiatives can increase patient safety, reduce resistance rates, decrease hospital costs, and improve patient clinical outcomes.