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.