Friday, November 15, 2013
This Is A Very Serious Problem That Needs A Solution If Clinical Decision Support Is To Make A Difference.
This appeared a little while ago.
October 31, 2013 | By Julie Bird
Providers override about half of the alerts they receive when using electronic prescribing systems, according to a new study that also finds only about half of those overrides are medically appropriate.
Researchers reviewed more than 150,000 clinical decision support (CDS) alerts on 2 million outpatient medication orders for the study, published online this week by the Journal of the American Medical Informatics Association (JAMIA).
The most common CDS alerts were duplicate drug (33 percent), patient allergy (17 percent) and drug interactions (16 percent.) Alerts most likely to be overridden, however, were formulary substitutions (85 percent), age-based recommendations (79 percent), renal recommendations (78 percent) and patient allergies (77 percent).
On average, 53 percent of alert overrides were considered appropriate, according to the study abstract. Only 12 percent of renal recommendation alert overrides were deemed appropriate, compared with 92 percent for patient allergies.
The researchers concluded that refining the alerts could improve relevance and reduce alert fatigue.
Alert fatigue and other misuses of EHRs can cause serious problems.
More here with links.
I look forward to suggestions as to what can be done to keep this incidence low. Insist on a reason for the override being recorded maybe?
What do you think?
Posted by Dr David G More MB PhD at Friday, November 15, 2013