J Am Med Inform Assoc - Drug-drug interactions that should be non-interruptive in order to reduce alert fatigue in electronic health records.

Tópicos

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Resumo

JECTIVE: Alert fatigue represents a common problem associated with the use of clinical decision support systems in electronic health records (EHR). This problem is particularly profound with drug-drug interaction (DDI) alerts for which studies have reported override rates of approximately 90%. The objective of this study is to report consensus-based recommendations of an expert panel on DDI that can be safely made non-interruptive to the provider's workflow, in EHR, in an attempt to reduce alert fatigue.METHODS: We utilized an expert panel process to rate the interactions. Panelists had expertise in medicine, pharmacy, pharmacology and clinical informatics, and represented both academic institutions and vendors of medication knowledge bases and EHR. In addition, representatives from the US Food and Drug Administration and the American Society of Health-System Pharmacy contributed to the discussions.RESULTS: Recommendations and considerations of the panel resulted in the creation of a list of 33 class-based low-priority DDI that do not warrant being interruptive alerts in EHR. In one institution, these accounted for 36% of the interactions displayed.DISCUSSION: Development and customization of the content of medication knowledge bases that drive DDI alerting represents a resource-intensive task. Creation of a standardized list of low-priority DDI may help reduce alert fatigue across EHR.CONCLUSIONS: Future efforts might include the development of a consortium to maintain this list over time. Such a list could also be used in conjunction with financial incentives tied to its adoption in EHR.

Resumo Limpo

jectiv alert fatigu repres common problem associ use clinic decis support system electron health record ehr problem particular profound drugdrug interact ddi alert studi report overrid rate approxim object studi report consensusbas recommend expert panel ddi can safe made noninterrupt provid workflow ehr attempt reduc alert fatiguemethod util expert panel process rate interact panelist expertis medicin pharmaci pharmacolog clinic informat repres academ institut vendor medic knowledg base ehr addit repres us food drug administr american societi healthsystem pharmaci contribut discussionsresult recommend consider panel result creation list classbas lowprior ddi warrant interrupt alert ehr one institut account interact displayeddiscuss develop custom content medic knowledg base drive ddi alert repres resourceintens task creation standard list lowprior ddi may help reduc alert fatigu across ehrconclus futur effort might includ develop consortium maintain list time list also use conjunct financi incent tie adopt ehr

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