Applied Clinical Informatics, Table of Contents Appl Clin Inform 2010; 01(03): 346-362DOI: 10.4338/ACI-2009-11-RA-0014 Research Article Schattauer GmbH Decision Support Alerts for Medication Ordering in a Computerized Provider Order Entry (CPOE) System A systematic approach to decrease alerts M. A. Del Beccaro 1 Seattle Children’s Hospital, Seattle Washington 2 Department of Pediatrics, University of Washington School of Medicine, Seattle Washington , R. Villanueva 1 Seattle Children’s Hospital, Seattle Washington , K. M. Knudson 1 Seattle Children’s Hospital, Seattle Washington , E. M. Harvey 1 Seattle Children’s Hospital, Seattle Washington , J. M. Langle 1 Seattle Children’s Hospital, Seattle Washington , W. Paul 1 Seattle Children’s Hospital, Seattle Washington › Author Affiliations Recommend Article Abstract Full Text PDF Download Keywords KeywordsComputerized provider order entry - CPOE - clinical decision support - alert fatigue References References 1 Kohn LT, Corrigan JM, Donaldson MS. eds. To Err Is Human: Building a Safer Health System. Institute of Medicine Committee on Quality Health Care in America. Washington DC: National Academy Press; 1999 2 Leapfrog Group.. Leapfrog hospital survey results. Available at: www.leapfroggroup.org/for_hospitals/leapfrog_safety_practices/cpoe . 3 Fortescue EB. et al. Prioritizing strategies for preventing medication errors and adverse drug events in pediatric inpatients. Pediatrics 2003; 111: 722-729. 4 King WJ. et al. The effect of computerized physician order entry on medication errors and adverse drug events in pediatric inpatients. Pediatrics 2003; 112: 506-509. 5 Potts AL. et al. Computerized physician order entry and medication errors in a pediatric critical care unit. Pediatrics 2004; 113: 59-63. 6 Holdsworth MT. et al. The effect of computerized prescriber order entry on the incidence of adverse drug events in pediatric inpatients. Pediatrics 2007; 120: 1058-1066. 7 Galanter WL, Polikiatis A, Didomenico RJ. A trial of automated safety alerts for inpatient digoxin use with computerized physician order entry?. JAMIA 2004; 11: 270-277. 8 Galanter WL, Didomenico RJ, Polikiatis A. A trial of automated decision support alerts for contraindicated medications using computerized physician order entry. JAMIA 2005; 12: 269-274. 9 Steele AW. et al. The effect of automated alerts on provider ordering behavior in an outpatient setting. PLoS Med. 2005; 2 (09) e255. Epub 2005 Sep 6. online at www.plosmedicine.org . 10 Evans RS. et al. Improving empiric antibiotic selection using computer decision support. Arch Intern Med 1994; 154 (08) 878-884. 11 Smith DH. et al. The impact of prescribing safety alerts for elderly persons in an electronic medical record. Arch Intern Med 2006; 166: 1098-1104. 12 Kaushal R, Shojania KG, Bates DW. Effects of computerized physician order entry and clinical decision support systems on medication safety. A systematic review. Arch Intern Med 2003; 163: 1409-1416. 13 van der Sijs H, Aarts J, Vulto A, Berg M. Overriding of drug safety alerts in computerized physician order entry. JAMIA 2006; 13: 138-147. 14 Killelea BK, Kaushal R, Cooper M, Kuperman GJ. To what extent do pediatricians accept computer-based dosing suggestions?. Pediatrics 2007; 119: e69-e75. 15 Judge J. et. al. Prescribers’ responses to alerts during medication ordering in the long term care setting. JAMIA 2006; 13: 285-390. 16 Lin CP. et al. Evaluating clinical decision support systems: Monitoring CPOE order check override rates in the Department of Veterans Affairs’ computerized patient record system. JAMIA 2008; 15: 620-626. 17 Isaac T. et al. Overrides of medication alerts in ambulatory care. Arch Int Med 2009; 169 (03) 305-311. 18 Ash JS. et al. The extent and importance of unintended consequences related computerized provider order entry. JAMIA 2007; 14: 415-423. 19 Glassman PA. et al. Exposure to automated drug alerts over time: effects on clinicians’ knowledge and perceptions. Med Care 2006; 44 (03) 250-256. 20 Reichley RM. et al. Implementing a commercial rule base as a medication order safety net. JAMIA 2005; 12: 383-389. 21 Zwart-van Rijkom JEF. et al. Frequency and nature of drug–drug interactions in a Dutch university hospital. Br J Clin Pharmacol 2009; 68 (Suppl. 02) 187-193. 22 Paterno MD. et. al. Tiering drug-drug interaction alerts by severity increases compliance rates. JAMIA 2009; 16: 40-46. 23 van der Sijs H. et al. Turning off frequently overridden drug alerts: limited opportunities for doing it safely. JAMIA 2008; 15: 439-448. 24 Kim GR, Lehmann C. and the Council on Clinical Information Technology. Pediatric aspects of inpatient health information technology systems. Pediatrics 2008; 122: e1287-296.
