Int J Med Inform - Usability evaluation of pharmacogenomics clinical decision support aids and clinical knowledge resources in a computerized provider order entry system: a mixed methods approach.

Tópicos

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

Resumo

CKGROUND: Pharmacogenomics (PGx) is positioned to have a widespread impact on the practice of medicine, yet physician acceptance is low. The presentation of context-specific PGx information, in the form of clinical decision support (CDS) alerts embedded in a computerized provider order entry (CPOE) system, can aid uptake. Usability evaluations can inform optimal design, which, in turn, can spur adoption.OBJECTIVES: The study objectives were to: (1) evaluate an early prototype, commercial CPOE system with PGx-CDS alerts in a simulated environment, (2) identify potential improvements to the system user interface, and (3) understand the contexts under which PGx knowledge embedded in an electronic health record is useful to prescribers.METHODS: Using a mixed methods approach, we presented seven cardiologists and three oncologists with five hypothetical clinical case scenarios. Each scenario featured a drug for which a gene encoding drug metabolizing enzyme required consideration of dosage adjustment. We used Morae(?) to capture comments and on-screen movements as participants prescribed each drug. In addition to PGx-CDS alerts, 'Infobutton(?)' and 'Evidence' icons provided participants with clinical knowledge resources to aid decision-making.RESULTS: Nine themes emerged. Five suggested minor improvements to the CPOE user interface; two suggested presenting PGx information through PGx-CDS alerts using an 'Infobutton' or 'Evidence' icon. The remaining themes were strong recommendations to provide succinct, relevant guidelines and dosing recommendations of phenotypic information from credible and trustworthy sources; any more information was overwhelming. Participants' median rating of PGx-CDS system usability was 2 on a Likert scale ranging from 1 (strongly agree) to 7 (strongly disagree).CONCLUSIONS: Usability evaluation results suggest that participants considered PGx information important for improving prescribing decisions; and that they would incorporate PGx-CDS when information is presented in relevant and useful ways.

Resumo Limpo

ckground pharmacogenom pgx posit widespread impact practic medicin yet physician accept low present contextspecif pgx inform form clinic decis support cds alert embed computer provid order entri cpoe system can aid uptak usabl evalu can inform optim design turn can spur adoptionobject studi object evalu earli prototyp commerci cpoe system pgxcds alert simul environ identifi potenti improv system user interfac understand context pgx knowledg embed electron health record use prescribersmethod use mix method approach present seven cardiologist three oncologist five hypothet clinic case scenario scenario featur drug gene encod drug metabol enzym requir consider dosag adjust use mora captur comment onscreen movement particip prescrib drug addit pgxcds alert infobutton evid icon provid particip clinic knowledg resourc aid decisionmakingresult nine theme emerg five suggest minor improv cpoe user interfac two suggest present pgx inform pgxcds alert use infobutton evid icon remain theme strong recommend provid succinct relev guidelin dose recommend phenotyp inform credibl trustworthi sourc inform overwhelm particip median rate pgxcds system usabl likert scale rang strong agre strong disagreeconclus usabl evalu result suggest particip consid pgx inform import improv prescrib decis incorpor pgxcds inform present relev use way

Resumos Similares

Artif Intell Med - Safety and usability evaluation of a web-based insulin self-titration system for patients with type 2 diabetes mellitus. ( 0,828579205777452 )
Appl Clin Inform - Analysis of electronic medication orders with large overdoses: opportunities for mitigating dosing errors. ( 0,768159433140533 )
AMIA Annu Symp Proc - Medical alert management: a real-time adaptive decision support tool to reduce alert fatigue. ( 0,75340095184862 )
Comput Methods Programs Biomed - Developing guideline-based decision support systems using prot?g? and jess. ( 0,751487788917749 )
Int J Med Inform - Evaluation of medication dose alerts in pediatric inpatients. ( 0,743915091428128 )
J Am Med Inform Assoc - How to improve the delivery of medication alerts within computerized physician order entry systems: an international Delphi study. ( 0,740278996010563 )
Int J Med Inform - Technology-related medication errors in a tertiary hospital: a 5-year analysis of reported medication incidents. ( 0,738082121410942 )
AMIA Annu Symp Proc - A successful model and visual design for creating context-aware drug-drug interaction alerts. ( 0,735628468697082 )
AMIA Annu Symp Proc - Improving Patient Safety through Medical Alert Management: An Automated Decision Tool to Reduce Alert Fatigue. ( 0,732741879410362 )
AMIA Annu Symp Proc - Reducing wrong patient selection errors: exploring the design space of user interface techniques. ( 0,731381640340751 )
J Am Med Inform Assoc - Applying human factors principles to alert design increases efficiency and reduces prescribing errors in a scenario-based simulation. ( 0,729957678918903 )
J Am Med Inform Assoc - Making electronic prescribing alerts more effective: scenario-based experimental study in junior doctors. ( 0,729298895955567 )
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. ( 0,728563660804982 )
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. ( 0,726258910008941 )
J Am Med Inform Assoc - Development and use of active clinical decision support for preemptive pharmacogenomics. ( 0,725067362322086 )
Med Decis Making - Better medicine by default. ( 0,724785665664881 )
J Am Med Inform Assoc - Failure to utilize functions of an electronic prescribing system and the subsequent generation of 'technically preventable' computerized alerts. ( 0,722598291832274 )
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. ( 0,721177055622001 )
AMIA Annu Symp Proc - Improving patient safety by modifying provider ordering behavior using alerts (CDSS) in CPOE system. ( 0,720812852578242 )
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. ( 0,718983336063477 )
Appl Clin Inform - Decision Support Alerts for Medication Ordering in a Computerized Provider Order Entry (CPOE) System: A systematic approach to decrease alerts. ( 0,718881767496625 )
Int J Med Inform - Misspellings in drug information system queries: characteristics of drug name spelling errors and strategies for their prevention. ( 0,71879909852574 )
Comput Methods Programs Biomed - Physicians' responses to computerized drug-drug interaction alerts for outpatients. ( 0,718611978871648 )
J Am Med Inform Assoc - Development and preliminary evidence for the validity of an instrument assessing implementation of human-factors principles in medication-related decision-support systems--I-MeDeSA. ( 0,717546178720572 )
Appl Clin Inform - Drug interaction alert override rates in the Meaningful Use era: no evidence of progress. ( 0,715300340251436 )
BMC Med Inform Decis Mak - Development of a context model to prioritize drug safety alerts in CPOE systems. ( 0,7145082547446 )
J Am Med Inform Assoc - Errors associated with outpatient computerized prescribing systems. ( 0,714271047891286 )
Appl Clin Inform - Effect of EHR user interface changes on internal prescription discrepancies. ( 0,712094051351371 )
Telemed J E Health - Rural inpatient telepharmacy consultation demonstration for after-hours medication review. ( 0,711815106356339 )
J Am Med Inform Assoc - Ambulatory prescribing errors among community-based providers in two states. ( 0,71181474158467 )
J Am Med Inform Assoc - Appropriateness of commercially available and partially customized medication dosing alerts among pediatric patients. ( 0,710392968618474 )
Methods Inf Med - From adverse drug event detection to prevention. A novel clinical decision support framework for medication safety. ( 0,708731608666485 )
Perspect Health Inf Manag - Can utilizing a computerized provider order entry (CPOE) system prevent hospital medical errors and adverse drug events? ( 0,707928805449468 )
J Am Med Inform Assoc - Understanding and preventing wrong-patient electronic orders: a randomized controlled trial. ( 0,706533783910435 )
Appl Clin Inform - Reducing risk with clinical decision support: a study of closed malpractice claims. ( 0,705342814234715 )
J Am Med Inform Assoc - Sensitivity and specificity of dosing alerts for dosing errors among hospitalized pediatric patients. ( 0,705149273473465 )
Int J Med Inform - What, if all alerts were specific - estimating the potential impact on drug interaction alert burden. ( 0,704837037283469 )
J Am Med Inform Assoc - Factors contributing to an increase in duplicate medication order errors after CPOE implementation. ( 0,704049169617287 )
Appl Clin Inform - Response to medication dosing alerts for pediatric inpatients using a computerized provider order entry system. ( 0,703869292599019 )
Int J Med Inform - Assessment of efficiency and safety of the comprehensive Chemotherapy Assistance Program for ordering oncology medications. ( 0,703329590359732 )
Int J Med Inform - Prescription order risk factors for pediatric dosing alerts. ( 0,702477286202319 )
J Am Med Inform Assoc - Factors influencing alert acceptance: a novel approach for predicting the success of clinical decision support. ( 0,701711512309446 )
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. ( 0,700821889461507 )
Appl Clin Inform - A trial of inpatient indication based prescribing during computerized order entry with medications commonly used off-label. ( 0,699758426194122 )
J Am Med Inform Assoc - Overrides of medication-related clinical decision support alerts in outpatients. ( 0,699240117103392 )
AMIA Annu Symp Proc - An analysis and recommendations for multidisciplinary computerized handoff applications in hospitals. ( 0,698464428868934 )
Comput Methods Programs Biomed - A smart medication recommendation model for the electronic prescription. ( 0,6978280264123 )
J Med Syst - Two RFID-based solutions for secure inpatient medication administration. ( 0,696138428519823 )
J Am Med Inform Assoc - Indication-based prescribing prevents wrong-patient medication errors in computerized provider order entry (CPOE). ( 0,69605924914957 )
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. ( 0,695471096225034 )
J Am Med Inform Assoc - Evaluation of medium-term consequences of implementing commercial computerized physician order entry and clinical decision support prescribing systems in two 'early adopter' hospitals. ( 0,69455691502877 )
AMIA Annu Symp Proc - Factors Contributing to CPOE Opiate Allergy Alert Overrides. ( 0,694431033043218 )
J Am Med Inform Assoc - Temporal and other factors that influence the time doctors take to prescribe using an electronic prescribing system. ( 0,692820369678196 )
J Am Med Inform Assoc - The influence of computerized decision support on prescribing during ward-rounds: are the decision-makers targeted? ( 0,692582018417184 )
Int J Med Inform - Impact of a clinical decision support system for high-alert medications on the prevention of prescription errors. ( 0,690231203569789 )
J Am Med Inform Assoc - Prevalence of medication administration errors in two medical units with automated prescription and dispensing. ( 0,689884308562147 )
Comput Methods Programs Biomed - Potential drug-drug interactions in pediatric outpatient prescriptions for newborns and infants. ( 0,688520244552959 )
J Am Med Inform Assoc - A clinical data warehouse-based process for refining medication orders alerts. ( 0,688176207644306 )
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. ( 0,686684719487679 )
Int J Med Inform - Junior doctors' prescribing work after-hours and the impact of computerized decision support. ( 0,686611450009089 )
AMIA Annu Symp Proc - Analyzing U.S. prescription lists with RxNorm and the ATC/DDD Index. ( 0,686139626179227 )
J Am Med Inform Assoc - Evaluating the accuracy of electronic pediatric drug dosing rules. ( 0,684726966763301 )
J Am Med Inform Assoc - A randomized-controlled trial of computerized alerts to reduce unapproved medication abbreviation use. ( 0,684326787658761 )
J Am Med Inform Assoc - A framework for evaluating the appropriateness of clinical decision support alerts and responses. ( 0,683808466770494 )
J Am Med Inform Assoc - Integrating pharmacogenetic information and clinical decision support into the electronic health record. ( 0,682538894347222 )
Perspect Health Inf Manag - Enhance the accuracy of medication histories for the elderly by using an electronic medication checklist. ( 0,681184828354711 )
J Med Syst - Development of a point-of-care HIV/AIDS medication dosing support system using the Android mobile platform. ( 0,679839883575222 )
Methods Inf Med - Attitude of physicians towards automatic alerting in computerized physician order entry systems. A comparative international survey. ( 0,679740554953486 )
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. ( 0,679703605440445 )
BMC Med Inform Decis Mak - Effect of electronic prescribing with formulary decision support on medication tier, copayments, and adherence. ( 0,677306503037565 )
AMIA Annu Symp Proc - Ontological approach for safe and effective polypharmacy prescription. ( 0,676957412552388 )
J Am Med Inform Assoc - Characteristics and effects of nurse dosing over-rides on computer-based intensive insulin therapy protocol performance. ( 0,674889235856768 )
J Am Med Inform Assoc - Don't fuel the fire: decreasing intravenous haloperidol use in high risk patients via a customized electronic alert. ( 0,67253761897474 )
Appl Clin Inform - Duplicate orders: an unintended consequence of computerized provider/physician order entry (CPOE) implementation: analysis and mitigation strategies. ( 0,67186869055509 )
Artif Intell Med - Physicians' responses to clinical decision support on an intensive care unit--comparison of four different alerting methods. ( 0,671173677606609 )
J Biomed Inform - Interface design principles for usable decision support: a targeted review of best practices for clinical prescribing interventions. ( 0,670727600538444 )
J Am Med Inform Assoc - Relationship between medication event rates and the Leapfrog computerized physician order entry evaluation tool. ( 0,669633670695584 )
Int J Med Inform - Cost-effectiveness of an electronic medication ordering system (CPOE/CDSS) in hospitalized patients. ( 0,66860076456646 )
Med Decis Making - Electronic notifications about drug substitutes can change physician prescription habits: a cross-sectional observational study. ( 0,665533394650474 )
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. ( 0,665130674062107 )
Appl Clin Inform - Cognitive analysis of decision support for antibiotic ordering in a neonatal intensive care unit. ( 0,664070228866277 )
AMIA Annu Symp Proc - Unexpected effects of unintended consequences: EMR prescription discrepancies and hemorrhage in patients on warfarin. ( 0,661430938766239 )
Int J Med Inform - Comparing the working time between Bar-Code Medication Administration system and traditional medication administration system: an observational study. ( 0,660071306519325 )
Int J Med Inform - Evaluation of the pilot program on the real-time drug utilization review system in South Korea. ( 0,659065168480275 )
J Am Med Inform Assoc - Classification of medication incidents associated with information technology. ( 0,657124482582834 )
J Am Med Inform Assoc - Guided medication dosing for elderly emergency patients using real-time, computerized decision support. ( 0,656013152093095 )
Appl Clin Inform - Medication safety improves after implementation of positive patient identification. ( 0,654224536600266 )
J Am Med Inform Assoc - Unrealized potential and residual consequences of electronic prescribing on pharmacy workflow in the outpatient pharmacy. ( 0,653234426809283 )
Int J Med Inform - A trial of indication based prescribing of antihypertensive medications during computerized order entry to improve problem list documentation. ( 0,651462321354397 )
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. ( 0,6507640801626 )
AMIA Annu Symp Proc - Effectiveness of bar coded medication alerts for elevated potassium. ( 0,650467097743116 )
J Am Med Inform Assoc - Prescribers' expectations and barriers to electronic prescribing of controlled substances. ( 0,648969766434199 )
J Am Med Inform Assoc - Reduction in medication errors in hospitals due to adoption of computerized provider order entry systems. ( 0,64829997231121 )
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. ( 0,644264970397862 )
J Clin Monit Comput - A technical description of a novel pharmacological anesthesia robot. ( 0,642647333079082 )
J Biomed Inform - Assessing the reliability of an automated dose-rounding algorithm. ( 0,641601741603937 )
Appl Clin Inform - Evaluation of a Korean version of a tool for assessing the incorporation of human factors into a medication-related decision support system: the I-MeDeSA. ( 0,64059845231034 )
Int J Med Inform - Coded entry versus free-text and alert overrides: what you get depends on how you ask. ( 0,640003472978177 )
J Am Med Inform Assoc - Paving the COWpath: data-driven design of pediatric order sets. ( 0,638916197416921 )
Health Informatics J - Implementation of smart pump technology in a paediatric intensive care unit. ( 0,638825808611919 )