J Am Med Inform Assoc - Paving the COWpath: data-driven design of pediatric order sets.

Tópicos

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

Resumo

JECTIVE: Evidence indicates that users incur significant physical and cognitive costs in the use of order sets, a core feature of computerized provider order entry systems. This paper develops data-driven approaches for automating the construction of order sets that match closely with user preferences and workflow while minimizing physical and cognitive workload.MATERIALS AND METHODS: We developed and tested optimization-based models embedded with clustering techniques using physical and cognitive click cost criteria. By judiciously learning from users' actual actions, our methods identify items for constituting order sets that are relevant according to historical ordering data and grouped on the basis of order similarity and ordering time. We evaluated performance of the methods using 47,099 orders from the year 2011 for asthma, appendectomy and pneumonia management in a pediatric inpatient setting.RESULTS: In comparison with existing order sets, those developed using the new approach significantly reduce the physical and cognitive workload associated with usage by 14-52%. This approach is also capable of accommodating variations in clinical conditions that affect order set usage and development.DISCUSSION: There is a critical need to investigate the cognitive complexity imposed on users by complex clinical information systems, and to design their features according to 'human factors' best practices. Optimizing order set generation using cognitive cost criteria introduces a new approach that can potentially improve ordering efficiency, reduce unintended variations in order placement, and enhance patient safety.CONCLUSIONS: We demonstrate that data-driven methods offer a promising approach for designing order sets that are generalizable, data-driven, condition-based, and up to date with current best practices.

Resumo Limpo

jectiv evid indic user incur signific physic cognit cost use order set core featur computer provid order entri system paper develop datadriven approach autom construct order set match close user prefer workflow minim physic cognit workloadmateri method develop test optimizationbas model embed cluster techniqu use physic cognit click cost criteria judici learn user actual action method identifi item constitut order set relev accord histor order data group basi order similar order time evalu perform method use order year asthma appendectomi pneumonia manag pediatr inpati settingresult comparison exist order set develop use new approach signific reduc physic cognit workload associ usag approach also capabl accommod variat clinic condit affect order set usag developmentdiscuss critic need investig cognit complex impos user complex clinic inform system design featur accord human factor best practic optim order set generat use cognit cost criteria introduc new approach can potenti improv order effici reduc unintend variat order placement enhanc patient safetyconclus demonstr datadriven method offer promis approach design order set generaliz datadriven conditionbas date current best practic

Resumos Similares

J Am Med Inform Assoc - Factors contributing to an increase in duplicate medication order errors after CPOE implementation. ( 0,780696042260452 )
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. ( 0,777518648076174 )
J Am Med Inform Assoc - Understanding and preventing wrong-patient electronic orders: a randomized controlled trial. ( 0,773178466975611 )
J Am Med Inform Assoc - Failure to utilize functions of an electronic prescribing system and the subsequent generation of 'technically preventable' computerized alerts. ( 0,769563091400433 )
Int J Med Inform - Prescription order risk factors for pediatric dosing alerts. ( 0,765953973980115 )
J Am Med Inform Assoc - Applying human factors principles to alert design increases efficiency and reduces prescribing errors in a scenario-based simulation. ( 0,763335734122047 )
Med Decis Making - Electronic notifications about drug substitutes can change physician prescription habits: a cross-sectional observational study. ( 0,761386008113228 )
J Am Med Inform Assoc - Overrides of medication-related clinical decision support alerts in outpatients. ( 0,761269752992793 )
Appl Clin Inform - Effect of EHR user interface changes on internal prescription discrepancies. ( 0,760253201357119 )
Comput Methods Programs Biomed - A smart medication recommendation model for the electronic prescription. ( 0,758000167152121 )
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. ( 0,75665903546219 )
J Telemed Telecare - Feasibility and accuracy of medication checks via Internet video. ( 0,756449878595785 )
J Am Med Inform Assoc - Errors associated with outpatient computerized prescribing systems. ( 0,756408275507693 )
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. ( 0,751493621427802 )
J Am Med Inform Assoc - Integrating pharmacogenetic information and clinical decision support into the electronic health record. ( 0,751216449112089 )
J Am Med Inform Assoc - How to improve the delivery of medication alerts within computerized physician order entry systems: an international Delphi study. ( 0,750131973820715 )
Comput Methods Programs Biomed - Developing guideline-based decision support systems using prot?g? and jess. ( 0,745754318750025 )
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. ( 0,745165079767218 )
AMIA Annu Symp Proc - Improving patient safety by modifying provider ordering behavior using alerts (CDSS) in CPOE system. ( 0,744963497584485 )
Int J Med Inform - Assessment of efficiency and safety of the comprehensive Chemotherapy Assistance Program for ordering oncology medications. ( 0,744895855273879 )
J Am Med Inform Assoc - Appropriateness of commercially available and partially customized medication dosing alerts among pediatric patients. ( 0,743729269016072 )
AMIA Annu Symp Proc - Improving Patient Safety through Medical Alert Management: An Automated Decision Tool to Reduce Alert Fatigue. ( 0,743388074166204 )
Int J Med Inform - Technology-related medication errors in a tertiary hospital: a 5-year analysis of reported medication incidents. ( 0,742062893899102 )
J Am Med Inform Assoc - Don't fuel the fire: decreasing intravenous haloperidol use in high risk patients via a customized electronic alert. ( 0,74041959617991 )
J Med Syst - Development of a point-of-care HIV/AIDS medication dosing support system using the Android mobile platform. ( 0,74006022557238 )
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. ( 0,73931821904182 )
Appl Clin Inform - Medication safety improves after implementation of positive patient identification. ( 0,738785638908188 )
BMC Med Inform Decis Mak - Effect of electronic prescribing with formulary decision support on medication tier, copayments, and adherence. ( 0,738668485061648 )
J Am Med Inform Assoc - Ambulatory prescribing errors among community-based providers in two states. ( 0,736106530242093 )
J Am Med Inform Assoc - A clinical data warehouse-based process for refining medication orders alerts. ( 0,735571704921304 )
J Am Med Inform Assoc - Prevalence of medication administration errors in two medical units with automated prescription and dispensing. ( 0,735381901576513 )
Telemed J E Health - Rural inpatient telepharmacy consultation demonstration for after-hours medication review. ( 0,735361535550448 )
Int J Med Inform - Junior doctors' prescribing work after-hours and the impact of computerized decision support. ( 0,735148267876555 )
Int J Med Inform - What, if all alerts were specific - estimating the potential impact on drug interaction alert burden. ( 0,735000230122567 )
J Am Med Inform Assoc - Making electronic prescribing alerts more effective: scenario-based experimental study in junior doctors. ( 0,734333552755111 )
AMIA Annu Symp Proc - Unexpected effects of unintended consequences: EMR prescription discrepancies and hemorrhage in patients on warfarin. ( 0,734016961425966 )
Appl Clin Inform - Decision Support Alerts for Medication Ordering in a Computerized Provider Order Entry (CPOE) System: A systematic approach to decrease alerts. ( 0,733942757621612 )
J Am Med Inform Assoc - A framework for evaluating the appropriateness of clinical decision support alerts and responses. ( 0,731959841534644 )
J Am Med Inform Assoc - Evaluating the accuracy of electronic pediatric drug dosing rules. ( 0,7305909176575 )
Appl Clin Inform - Response to medication dosing alerts for pediatric inpatients using a computerized provider order entry system. ( 0,730469909010245 )
Int J Med Inform - A trial of indication based prescribing of antihypertensive medications during computerized order entry to improve problem list documentation. ( 0,72798722891937 )
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. ( 0,727555997308668 )
J Am Med Inform Assoc - Sensitivity and specificity of dosing alerts for dosing errors among hospitalized pediatric patients. ( 0,72721014415421 )
Int J Med Inform - Evaluation of medication dose alerts in pediatric inpatients. ( 0,726886378222085 )
J Med Syst - Two RFID-based solutions for secure inpatient medication administration. ( 0,725333080476144 )
J Am Med Inform Assoc - Development and use of active clinical decision support for preemptive pharmacogenomics. ( 0,725275408213846 )
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. ( 0,724377566728258 )
Int J Med Inform - Cost-effectiveness of an electronic medication ordering system (CPOE/CDSS) in hospitalized patients. ( 0,723575778094851 )
J Am Med Inform Assoc - A randomized-controlled trial of computerized alerts to reduce unapproved medication abbreviation use. ( 0,723569350010589 )
Comput Methods Programs Biomed - Physicians' responses to computerized drug-drug interaction alerts for outpatients. ( 0,722500489407399 )
Appl Clin Inform - Drug interaction alert override rates in the Meaningful Use era: no evidence of progress. ( 0,717785593405257 )
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. ( 0,716262044114483 )
Appl Clin Inform - Analysis of electronic medication orders with large overdoses: opportunities for mitigating dosing errors. ( 0,716129037563807 )
Health Informatics J - Statistical classification of drug incidents due to look-alike sound-alike mix-ups. ( 0,714344619194251 )
Appl Clin Inform - Duplicate orders: an unintended consequence of computerized provider/physician order entry (CPOE) implementation: analysis and mitigation strategies. ( 0,713155473885281 )
Int J Med Inform - Impact of a clinical decision support system for high-alert medications on the prevention of prescription errors. ( 0,713079997001228 )
AMIA Annu Symp Proc - Effectiveness of bar coded medication alerts for elevated potassium. ( 0,712930129033765 )
J Am Med Inform Assoc - Reduction in medication errors in hospitals due to adoption of computerized provider order entry systems. ( 0,71257297264869 )
J Am Med Inform Assoc - Temporal and other factors that influence the time doctors take to prescribe using an electronic prescribing system. ( 0,712344615655853 )
J Am Med Inform Assoc - Classification of medication incidents associated with information technology. ( 0,711872276614333 )
Perspect Health Inf Manag - Enhance the accuracy of medication histories for the elderly by using an electronic medication checklist. ( 0,711833481324393 )
Artif Intell Med - Safety and usability evaluation of a web-based insulin self-titration system for patients with type 2 diabetes mellitus. ( 0,711636991757158 )
Health Informatics J - Implementation of smart pump technology in a paediatric intensive care unit. ( 0,7085410972434 )
Perspect Health Inf Manag - Can utilizing a computerized provider order entry (CPOE) system prevent hospital medical errors and adverse drug events? ( 0,707119352309 )
J Am Med Inform Assoc - Indication-based prescribing prevents wrong-patient medication errors in computerized provider order entry (CPOE). ( 0,705912467966923 )
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. ( 0,705297280230028 )
Appl Clin Inform - Electronic medical record prompts for lab orders in patients initiating statins. ( 0,704957251730572 )
J Am Med Inform Assoc - Prescribers' expectations and barriers to electronic prescribing of controlled substances. ( 0,70267346612776 )
AMIA Annu Symp Proc - An analysis and recommendations for multidisciplinary computerized handoff applications in hospitals. ( 0,700417155469067 )
AMIA Annu Symp Proc - Medical alert management: a real-time adaptive decision support tool to reduce alert fatigue. ( 0,69470289093661 )
Int J Med Inform - A comprehensive RFID solution to enhance inpatient medication safety. ( 0,693023563179728 )
AMIA Annu Symp Proc - Reducing wrong patient selection errors: exploring the design space of user interface techniques. ( 0,692236284458268 )
Appl Clin Inform - AMDIS Case Conference: Intrusive Medication Safety Alerts. ( 0,690983431819224 )
Appl Clin Inform - A trial of inpatient indication based prescribing during computerized order entry with medications commonly used off-label. ( 0,690826390153851 )
BMC Med Inform Decis Mak - Development of a context model to prioritize drug safety alerts in CPOE systems. ( 0,690018299970918 )
Appl Clin Inform - Reducing risk with clinical decision support: a study of closed malpractice claims. ( 0,684164183448679 )
Int J Med Inform - Comparing the working time between Bar-Code Medication Administration system and traditional medication administration system: an observational study. ( 0,68103883713912 )
Med Decis Making - Better medicine by default. ( 0,679828924358284 )
AMIA Annu Symp Proc - Factors Contributing to CPOE Opiate Allergy Alert Overrides. ( 0,679565208571788 )
Methods Inf Med - From adverse drug event detection to prevention. A novel clinical decision support framework for medication safety. ( 0,678878315024592 )
J Am Med Inform Assoc - Unrealized potential and residual consequences of electronic prescribing on pharmacy workflow in the outpatient pharmacy. ( 0,678511306675198 )
J Am Med Inform Assoc - 'Too much, too late': mixed methods multi-channel video recording study of computerized decision support systems and GP prescribing. ( 0,678028149745444 )
Int J Med Inform - Misspellings in drug information system queries: characteristics of drug name spelling errors and strategies for their prevention. ( 0,675088596082479 )
AMIA Annu Symp Proc - Analyzing U.S. prescription lists with RxNorm and the ATC/DDD Index. ( 0,673317688883556 )
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. ( 0,671488666336258 )
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. ( 0,670954926549101 )
J Am Med Inform Assoc - Collaborative knowledge acquisition for the design of context-aware alert systems. ( 0,669825509797691 )
Int J Med Inform - SMS reminders improve adherence to oral medication in type 2 diabetes patients who are real time electronically monitored. ( 0,666153211939951 )
Int J Med Inform - An RFID solution for enhancing inpatient medication safety with real-time verifiable grouping-proof. ( 0,665514515157519 )
J Am Med Inform Assoc - Detecting pregnancy use of non-hormonal category X medications in electronic medical records. ( 0,664476062569935 )
Appl Clin Inform - Developing clinical decision support within a commercial electronic health record system to improve antimicrobial prescribing in the neonatal ICU. ( 0,662303416712047 )
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. ( 0,66055930614886 )
Appl Clin Inform - The influence of task environment and health literacy on the quality of parent-reported ADHD data. ( 0,659386587927492 )
J Am Med Inform Assoc - Immediate financial impact of computerized clinical decision support for long-term care residents with renal insufficiency: a case study. ( 0,657900723691194 )
Int J Med Inform - Evaluation of the pilot program on the real-time drug utilization review system in South Korea. ( 0,657324612636399 )
J Am Med Inform Assoc - Impact of clinical decision support on receipt of antibiotic prescriptions for acute bronchitis and upper respiratory tract infection. ( 0,657248239023358 )
Int J Med Inform - Coded entry versus free-text and alert overrides: what you get depends on how you ask. ( 0,657207164542179 )
AMIA Annu Symp Proc - Evaluating the effectiveness of clinical alerts: a signal detection approach. ( 0,654493081461451 )
J Am Med Inform Assoc - Factors influencing alert acceptance: a novel approach for predicting the success of clinical decision support. ( 0,651356519924063 )
AMIA Annu Symp Proc - How many medication orders are entered through free-text in EHRs?--a study on hypoglycemic agents. ( 0,651302705986995 )