Int J Med Inform - A trial of indication based prescribing of antihypertensive medications during computerized order entry to improve problem list documentation.

Tópicos

{ medic(1828) order(1363) alert(1069) }
{ can(774) often(719) complex(702) }
{ state(1844) use(1261) util(961) }
{ error(1145) method(1030) estim(1020) }
{ use(976) code(926) identifi(902) }
{ perform(999) metric(946) measur(919) }
{ record(1888) medic(1808) patient(1693) }
{ problem(2511) optim(1539) algorithm(950) }
{ studi(1410) differ(1259) use(1210) }
{ group(2977) signific(1463) compar(1072) }
{ care(1570) inform(1187) nurs(1089) }
{ intervent(3218) particip(2042) group(1664) }
{ estim(2440) model(1874) function(577) }
{ measur(2081) correl(1212) valu(896) }
{ bind(1733) structur(1185) ligand(1036) }
{ featur(3375) classif(2383) classifi(1994) }
{ chang(1828) time(1643) increas(1301) }
{ learn(2355) train(1041) set(1003) }
{ model(2220) cell(1177) simul(1124) }
{ cost(1906) reduc(1198) effect(832) }
{ time(1939) patient(1703) rate(768) }
{ can(981) present(881) function(850) }
{ analysi(2126) use(1163) compon(1037) }
{ detect(2391) sensit(1101) algorithm(908) }
{ model(3404) distribut(989) bayesian(671) }
{ imag(1947) propos(1133) code(1026) }
{ data(1737) use(1416) pattern(1282) }
{ inform(2794) health(2639) internet(1427) }
{ system(1976) rule(880) can(841) }
{ imag(1057) registr(996) error(939) }
{ sequenc(1873) structur(1644) protein(1328) }
{ method(1219) similar(1157) match(930) }
{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ patient(2315) diseas(1263) diabet(1191) }
{ take(945) account(800) differ(722) }
{ studi(2440) review(1878) systemat(933) }
{ motion(1329) object(1292) video(1091) }
{ assess(1506) score(1403) qualiti(1306) }
{ treatment(1704) effect(941) patient(846) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ framework(1458) process(801) describ(734) }
{ concept(1167) ontolog(924) domain(897) }
{ clinic(1479) use(1117) guidelin(835) }
{ algorithm(1844) comput(1787) effici(935) }
{ extract(1171) text(1153) clinic(932) }
{ method(1557) propos(1049) approach(1037) }
{ data(1714) softwar(1251) tool(1186) }
{ design(1359) user(1324) use(1319) }
{ control(1307) perform(991) simul(935) }
{ general(901) number(790) one(736) }
{ method(984) reconstruct(947) comput(926) }
{ search(2224) databas(1162) retriev(909) }
{ featur(1941) imag(1645) propos(1176) }
{ case(1353) use(1143) diagnosi(1136) }
{ howev(809) still(633) remain(590) }
{ data(3963) clinic(1234) research(1004) }
{ risk(3053) factor(974) diseas(938) }
{ research(1085) discuss(1038) issu(1018) }
{ system(1050) medic(1026) inform(1018) }
{ import(1318) role(1303) understand(862) }
{ model(2341) predict(2261) use(1141) }
{ visual(1396) interact(850) tool(830) }
{ compound(1573) activ(1297) structur(1058) }
{ perform(1367) use(1326) method(1137) }
{ studi(1119) effect(1106) posit(819) }
{ blood(1257) pressur(1144) flow(957) }
{ spatial(1525) area(1432) region(1030) }
{ health(3367) inform(1360) care(1135) }
{ model(3480) simul(1196) paramet(876) }
{ monitor(1329) mobil(1314) devic(1160) }
{ ehr(2073) health(1662) electron(1139) }
{ research(1218) medic(880) student(794) }
{ patient(2837) hospit(1953) medic(668) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ age(1611) year(1155) adult(843) }
{ signal(2180) analysi(812) frequenc(800) }
{ sampl(1606) size(1419) use(1276) }
{ gene(2352) biolog(1181) express(1162) }
{ data(3008) multipl(1320) sourc(1022) }
{ first(2504) two(1366) second(1323) }
{ activ(1138) subject(705) human(624) }
{ patient(1821) servic(1111) care(1106) }
{ use(2086) technolog(871) perceiv(783) }
{ health(1844) social(1437) communiti(874) }
{ structur(1116) can(940) graph(676) }
{ high(1669) rate(1365) level(1280) }
{ cancer(2502) breast(956) screen(824) }
{ use(1733) differ(960) four(931) }
{ drug(1928) target(777) effect(648) }
{ result(1111) use(1088) new(759) }
{ implement(1333) system(1263) develop(1122) }
{ survey(1388) particip(1329) question(1065) }
{ decis(3086) make(1611) patient(1517) }
{ process(1125) use(805) approach(778) }
{ activ(1452) weight(1219) physic(1104) }
{ method(1969) cluster(1462) data(1082) }
{ method(2212) result(1239) propos(1039) }

Resumo

CKGROUND: Maintenance of problem lists in electronic medical records is required for the meaningful use incentive and by the Joint Commission. Linking indication with prescribed medications using computerized physician order entry (CPOE) can improve problem list documentation. Prescribing of antihypertensive medications is an excellent target for interventions to improve indication-based prescribing because antihypertensive medications often have multiple indications and are frequently prescribed.OBJECTIVE: To measure the accuracy and completeness of electronic problem list additions using indication-based prescribing of antihypertensives.DESIGN: Clinical decision support (CDS) was implemented so that orders of antihypertensives prompted ordering physicians to select from problem list additions indicated by that medication. An observational analysis of 1000 alerts was performed to determine the accuracy of physicians' selections.RESULTS: At least one accurate problem was placed 57.5% of the time. Inaccurate problems were placed 4.8% of the time. Accuracy was lower in medications with multiple indications and the likelihood of omitted problems was higher compared to medications whose only indication was hypertension. Attending physicians outperformed other clinicians. There was somewhat lower accuracy for inpatients compared to outpatients.CONCLUSION: CDS using indication-based prescribing of antihypertensives produced accurate problem placement roughly two-thirds of time with fewer than 5% inaccurate problems placed. Performance of alerts was sensitive to the number of potential indications of the medication and attendings vs. other clinicians prescribing. Indication-based prescribing during CPOE can be used for problem list maintenance, but requires optimization.

Resumo Limpo

ckground mainten problem list electron medic record requir meaning use incent joint commiss link indic prescrib medic use computer physician order entri cpoe can improv problem list document prescrib antihypertens medic excel target intervent improv indicationbas prescrib antihypertens medic often multipl indic frequent prescribedobject measur accuraci complet electron problem list addit use indicationbas prescrib antihypertensivesdesign clinic decis support cds implement order antihypertens prompt order physician select problem list addit indic medic observ analysi alert perform determin accuraci physician selectionsresult least one accur problem place time inaccur problem place time accuraci lower medic multipl indic likelihood omit problem higher compar medic whose indic hypertens attend physician outperform clinician somewhat lower accuraci inpati compar outpatientsconclus cds use indicationbas prescrib antihypertens produc accur problem placement rough twothird time fewer inaccur problem place perform alert sensit number potenti indic medic attend vs clinician prescrib indicationbas prescrib cpoe can use problem list mainten requir optim

Resumos Similares

Int J Med Inform - Evaluation of medication dose alerts in pediatric inpatients. ( 0,928632715300597 )
Appl Clin Inform - Response to medication dosing alerts for pediatric inpatients using a computerized provider order entry system. ( 0,927226171851706 )
J Am Med Inform Assoc - Errors associated with outpatient computerized prescribing systems. ( 0,919807083740394 )
Appl Clin Inform - Decision Support Alerts for Medication Ordering in a Computerized Provider Order Entry (CPOE) System: A systematic approach to decrease alerts. ( 0,909803502258028 )
J Am Med Inform Assoc - Sensitivity and specificity of dosing alerts for dosing errors among hospitalized pediatric patients. ( 0,908731270813473 )
Telemed J E Health - Rural inpatient telepharmacy consultation demonstration for after-hours medication review. ( 0,908699912977934 )
J Am Med Inform Assoc - Appropriateness of commercially available and partially customized medication dosing alerts among pediatric patients. ( 0,907431747064474 )
J Am Med Inform Assoc - Clinical decision support for atypical orders: detection and warning of atypical medication orders submitted to a computerized provider order entry system. ( 0,904966712302933 )
J. Med. Internet Res. - Physician order entry or nurse order entry? Comparison of two implementation strategies for a computerized order entry system aimed at reducing dosing medication errors. ( 0,901301144749904 )
J Am Med Inform Assoc - Factors contributing to an increase in duplicate medication order errors after CPOE implementation. ( 0,900544330015461 )
J Am Med Inform Assoc - Understanding and preventing wrong-patient electronic orders: a randomized controlled trial. ( 0,898048561190917 )
Int J Med Inform - Prescription order risk factors for pediatric dosing alerts. ( 0,897897878995742 )
J Am Med Inform Assoc - Failure to utilize functions of an electronic prescribing system and the subsequent generation of 'technically preventable' computerized alerts. ( 0,896373461139247 )
J Am Med Inform Assoc - Impact of clinical decision support preventing the use of QT-prolonging medications for patients at risk for torsade de pointes. ( 0,890526467099027 )
J Am Med Inform Assoc - Overrides of medication-related clinical decision support alerts in outpatients. ( 0,890502369889488 )
AMIA Annu Symp Proc - Improving patient safety by modifying provider ordering behavior using alerts (CDSS) in CPOE system. ( 0,890334628878897 )
J Am Med Inform Assoc - Prevalence of medication administration errors in two medical units with automated prescription and dispensing. ( 0,88613676851887 )
J Am Med Inform Assoc - Indication-based prescribing prevents wrong-patient medication errors in computerized provider order entry (CPOE). ( 0,886028670974508 )
AMIA Annu Symp Proc - Improving Patient Safety through Medical Alert Management: An Automated Decision Tool to Reduce Alert Fatigue. ( 0,883454499215051 )
Comput Methods Programs Biomed - Physicians' responses to computerized drug-drug interaction alerts for outpatients. ( 0,882859137517364 )
J Med Syst - Two RFID-based solutions for secure inpatient medication administration. ( 0,88124324999526 )
J Am Med Inform Assoc - Don't fuel the fire: decreasing intravenous haloperidol use in high risk patients via a customized electronic alert. ( 0,881176869042179 )
J Am Med Inform Assoc - Ambulatory prescribing errors among community-based providers in two states. ( 0,879640842271196 )
J Am Med Inform Assoc - Evaluating the accuracy of electronic pediatric drug dosing rules. ( 0,876719351814208 )
Comput Methods Programs Biomed - A smart medication recommendation model for the electronic prescription. ( 0,875636668152741 )
Appl Clin Inform - Drug interaction alert override rates in the Meaningful Use era: no evidence of progress. ( 0,874134149284731 )
AMIA Annu Symp Proc - Unexpected effects of unintended consequences: EMR prescription discrepancies and hemorrhage in patients on warfarin. ( 0,870450782669467 )
Int J Med Inform - The effect of using the health smart card vs. CPOE reminder system on the prescribing practices of non-obstetric physicians during outpatient visits for pregnant women in Taiwan. ( 0,867749610411569 )
J Am Med Inform Assoc - Development and use of active clinical decision support for preemptive pharmacogenomics. ( 0,864326805968319 )
J Am Med Inform Assoc - Integrating pharmacogenetic information and clinical decision support into the electronic health record. ( 0,864014637548438 )
J Am Med Inform Assoc - Making electronic prescribing alerts more effective: scenario-based experimental study in junior doctors. ( 0,861602420756392 )
Appl Clin Inform - Effect of EHR user interface changes on internal prescription discrepancies. ( 0,857332740377785 )
J Am Med Inform Assoc - Classification of medication incidents associated with information technology. ( 0,857328240987497 )
Perspect Health Inf Manag - Enhance the accuracy of medication histories for the elderly by using an electronic medication checklist. ( 0,854963289931181 )
Int J Med Inform - Junior doctors' prescribing work after-hours and the impact of computerized decision support. ( 0,854530108627739 )
Int J Med Inform - Coded entry versus free-text and alert overrides: what you get depends on how you ask. ( 0,853308877526452 )
Appl Clin Inform - Duplicate orders: an unintended consequence of computerized provider/physician order entry (CPOE) implementation: analysis and mitigation strategies. ( 0,851986989748309 )
J Am Med Inform Assoc - A framework for evaluating the appropriateness of clinical decision support alerts and responses. ( 0,851646800166235 )
Int J Med Inform - Assessment of efficiency and safety of the comprehensive Chemotherapy Assistance Program for ordering oncology medications. ( 0,850738243625658 )
J Am Med Inform Assoc - Optimization of drug-drug interaction alert rules in a pediatric hospital's electronic health record system using a visual analytics dashboard. ( 0,848863703635422 )
J Am Med Inform Assoc - A randomized-controlled trial of computerized alerts to reduce unapproved medication abbreviation use. ( 0,847651722681717 )
Int J Med Inform - Validity of a clinical decision rule-based alert system for drug dose adjustment in patients with renal failure intended to improve pharmacists' analysis of medication orders in hospitals. ( 0,845733553907716 )
J Am Med Inform Assoc - Reduction in medication errors in hospitals due to adoption of computerized provider order entry systems. ( 0,845524469099963 )
J Am Med Inform Assoc - Applying human factors principles to alert design increases efficiency and reduces prescribing errors in a scenario-based simulation. ( 0,844372989309439 )
Int J Med Inform - Cost-effectiveness of an electronic medication ordering system (CPOE/CDSS) in hospitalized patients. ( 0,837231706462078 )
J Am Med Inform Assoc - How to improve the delivery of medication alerts within computerized physician order entry systems: an international Delphi study. ( 0,836427741136859 )
AMIA Annu Symp Proc - An analysis and recommendations for multidisciplinary computerized handoff applications in hospitals. ( 0,834509722966789 )
J Am Med Inform Assoc - Temporal and other factors that influence the time doctors take to prescribe using an electronic prescribing system. ( 0,834507488477545 )
J Med Syst - Development of a point-of-care HIV/AIDS medication dosing support system using the Android mobile platform. ( 0,834290090774461 )
Int J Med Inform - Impact of a clinical decision support system for high-alert medications on the prevention of prescription errors. ( 0,833774724371333 )
Comput Methods Programs Biomed - Developing guideline-based decision support systems using prot?g? and jess. ( 0,83324690726954 )
J Am Med Inform Assoc - A clinical data warehouse-based process for refining medication orders alerts. ( 0,831569689445163 )
Int J Med Inform - Technology-related medication errors in a tertiary hospital: a 5-year analysis of reported medication incidents. ( 0,829502236503397 )
Appl Clin Inform - Medication safety improves after implementation of positive patient identification. ( 0,829269189626995 )
Int J Med Inform - Comparing the working time between Bar-Code Medication Administration system and traditional medication administration system: an observational study. ( 0,825635594524847 )
AMIA Annu Symp Proc - I meant that med for Baylee not Bailey!: a mixed method study to identify incidence and risk factors for CPOE patient misidentification. ( 0,822398257810307 )
AMIA Annu Symp Proc - Factors Contributing to CPOE Opiate Allergy Alert Overrides. ( 0,82228557896938 )
J Am Med Inform Assoc - Detecting pregnancy use of non-hormonal category X medications in electronic medical records. ( 0,820369385749396 )
J Am Med Inform Assoc - Unrealized potential and residual consequences of electronic prescribing on pharmacy workflow in the outpatient pharmacy. ( 0,820051681973709 )
BMC Med Inform Decis Mak - Effect of electronic prescribing with formulary decision support on medication tier, copayments, and adherence. ( 0,816245938919063 )
J Am Med Inform Assoc - The safety of electronic prescribing: manifestations, mechanisms, and rates of system-related errors associated with two commercial systems in hospitals. ( 0,8151568475415 )
Med Decis Making - Electronic notifications about drug substitutes can change physician prescription habits: a cross-sectional observational study. ( 0,814362928025661 )
Perspect Health Inf Manag - Can utilizing a computerized provider order entry (CPOE) system prevent hospital medical errors and adverse drug events? ( 0,812513599818228 )
Int J Med Inform - What, if all alerts were specific - estimating the potential impact on drug interaction alert burden. ( 0,811627895123483 )
J Am Med Inform Assoc - Impact of clinical decision support on receipt of antibiotic prescriptions for acute bronchitis and upper respiratory tract infection. ( 0,811254549865802 )
Int J Med Inform - Online detection of potential duplicate medications and changes of physician behavior for outpatients visiting multiple hospitals using national health insurance smart cards in Taiwan. ( 0,8105059264981 )
BMC Med Inform Decis Mak - Development of a context model to prioritize drug safety alerts in CPOE systems. ( 0,805891171339226 )
Med Decis Making - Better medicine by default. ( 0,795450661973706 )
Artif Intell Med - Safety and usability evaluation of a web-based insulin self-titration system for patients with type 2 diabetes mellitus. ( 0,795043241480309 )
Artif Intell Med - Evaluation of rule effectiveness and positive predictive value of clinical rules in a Dutch clinical decision support system in daily hospital pharmacy practice. ( 0,793845187450859 )
AMIA Annu Symp Proc - Analyzing U.S. prescription lists with RxNorm and the ATC/DDD Index. ( 0,793287540908242 )
AMIA Annu Symp Proc - Reducing free-text communication orders placed by providers using association rule mining. ( 0,790086980103549 )
Methods Inf Med - Attitude of physicians towards automatic alerting in computerized physician order entry systems. A comparative international survey. ( 0,788764981933392 )
J Am Med Inform Assoc - Prescribers' expectations and barriers to electronic prescribing of controlled substances. ( 0,787286779279465 )
Health Informatics J - Effects of a computerized decision support system in improving pharmacological management in high-risk cardiovascular patients: A cluster-randomized open-label controlled trial. ( 0,786705928672381 )
Appl Clin Inform - Analysis of electronic medication orders with large overdoses: opportunities for mitigating dosing errors. ( 0,785794402500696 )
BMC Med Inform Decis Mak - Using a computerized provider order entry system to meet the unique prescribing needs of children: description of an advanced dosing model. ( 0,778223117646609 )
Methods Inf Med - From adverse drug event detection to prevention. A novel clinical decision support framework for medication safety. ( 0,776402641140175 )
J Am Med Inform Assoc - Guided medication dosing for elderly emergency patients using real-time, computerized decision support. ( 0,773037978329516 )
Appl Clin Inform - Reducing risk with clinical decision support: a study of closed malpractice claims. ( 0,772720901641874 )
AMIA Annu Symp Proc - Effectiveness of bar coded medication alerts for elevated potassium. ( 0,772066574031814 )
Health Informatics J - Statistical classification of drug incidents due to look-alike sound-alike mix-ups. ( 0,772037253294026 )
Artif Intell Med - Physicians' responses to clinical decision support on an intensive care unit--comparison of four different alerting methods. ( 0,768301168578428 )
Int J Med Inform - Impact of electronic order management on the timeliness of antibiotic administration in critical care patients. ( 0,76814369315309 )
Int J Med Inform - Evaluation of the pilot program on the real-time drug utilization review system in South Korea. ( 0,765712105179816 )
J Am Med Inform Assoc - 'Too much, too late': mixed methods multi-channel video recording study of computerized decision support systems and GP prescribing. ( 0,764409763881803 )
AMIA Annu Symp Proc - Reducing wrong patient selection errors: exploring the design space of user interface techniques. ( 0,764325301012852 )
Appl Clin Inform - Electronic medical record prompts for lab orders in patients initiating statins. ( 0,760548457771327 )
AMIA Annu Symp Proc - Ontological approach for safe and effective polypharmacy prescription. ( 0,759560740227405 )
Comput Methods Programs Biomed - Potential drug-drug interactions in pediatric outpatient prescriptions for newborns and infants. ( 0,756276018629193 )
J Am Med Inform Assoc - Characteristics and effects of nurse dosing over-rides on computer-based intensive insulin therapy protocol performance. ( 0,755675184834589 )
AMIA Annu Symp Proc - Medical alert management: a real-time adaptive decision support tool to reduce alert fatigue. ( 0,751521467715438 )
J Telemed Telecare - Feasibility and accuracy of medication checks via Internet video. ( 0,745852944276765 )
J Am Med Inform Assoc - Factors influencing alert acceptance: a novel approach for predicting the success of clinical decision support. ( 0,741696768568007 )
AMIA Annu Symp Proc - Evaluating the effectiveness of clinical alerts: a signal detection approach. ( 0,737915391946644 )
BMC Med Inform Decis Mak - Evaluation of a drug-drug interaction: fax alert intervention program. ( 0,736985755040314 )
Int J Med Inform - Misspellings in drug information system queries: characteristics of drug name spelling errors and strategies for their prevention. ( 0,73386886273862 )
Int J Med Inform - Prescribers' interactions with medication alerts at the point of prescribing: A multi-method, in situ investigation of the human-computer interaction. ( 0,731569827785224 )
Int J Med Inform - Functionality test for drug safety alerting in computerized physician order entry systems. ( 0,731455552904342 )
Appl Clin Inform - Computerized Physician Order Entry (CPOE) in pediatric and neonatal intensive care: Recommendations how to meet clinical requirements. ( 0,728323360038763 )