BMC Med Inform Decis Mak - On the alert: future priorities for alerts in clinical decision support for computerized physician order entry identified from a European workshop.

Tópicos

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Resumo

CKGROUND: Clinical decision support (CDS) for electronic prescribing systems (computerized physician order entry) should help prescribers in the safe and rational use of medicines. However, the best ways to alert users to unsafe or irrational prescribing are uncertain. Specifically, CDS systems may generate too many alerts, producing unwelcome distractions for prescribers, or too few alerts running the risk of overlooking possible harms. Obtaining the right balance of alerting to adequately improve patient safety should be a priority.METHODS: A workshop funded through the European Regional Development Fund was convened by the University Hospitals Birmingham NHS Foundation Trust to assess current knowledge on alerts in CDS and to reach a consensus on a future research agenda on this topic. Leading European researchers in CDS and alerts in electronic prescribing systems were invited to the workshop.RESULTS: We identified important knowledge gaps and suggest research priorities including (1) the need to determine the optimal sensitivity and specificity of alerts; (2) whether adaptation to the environment or characteristics of the user may improve alerts; and (3) whether modifying the timing and number of alerts will lead to improvements. We have also discussed the challenges and benefits of using naturalistic or experimental studies in the evaluation of alerts and suggested appropriate outcome measures.CONCLUSIONS: We have identified critical problems in CDS, which should help to guide priorities in research to evaluate alerts. It is hoped that this will spark the next generation of novel research from which practical steps can be taken to implement changes to CDS systems that will ultimately reduce alert fatigue and improve the design of future systems.

Resumo Limpo

ckground clinic decis support cds electron prescrib system computer physician order entri help prescrib safe ration use medicin howev best way alert user unsaf irrat prescrib uncertain specif cds system may generat mani alert produc unwelcom distract prescrib alert run risk overlook possibl harm obtain right balanc alert adequ improv patient safeti prioritymethod workshop fund european region develop fund conven univers hospit birmingham nhs foundat trust assess current knowledg alert cds reach consensus futur research agenda topic lead european research cds alert electron prescrib system invit workshopresult identifi import knowledg gap suggest research prioriti includ need determin optim sensit specif alert whether adapt environ characterist user may improv alert whether modifi time number alert will lead improv also discuss challeng benefit use naturalist experiment studi evalu alert suggest appropri outcom measuresconclus identifi critic problem cds help guid prioriti research evalu alert hope will spark next generat novel research practic step can taken implement chang cds system will ultim reduc alert fatigu improv design futur system

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