Variation in high-priority drug-drug interaction alerts across institutions and electronic health records
| Autor: | Jeremy Harper, Jennifer Westmorland, Brandi O'Kelley, Lipika Samal, Daniel R. Murphy, Hardeep Singh, Richard Schreiber, Carl V. Vartian, Dustin McEvoy, Angela Ai, Christoph U. Lehmann, Thu Trang T. Hickman, Skye Aaron, Adam Wright, Gregory M. Fraser, Mary G. Amato, Angela Kennemer, Eric J. Thomas, Allison B. McCoy, Sameer Malhotra, Dean F. Sittig, David W. Bauer, Michael A. Krall |
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| Rok vydání: | 2016 |
| Předmět: |
clinical decision support
drug-drug interactions 020205 medical informatics Standardization Medical Records Systems Computerized Health information technology Vendor Health Informatics Standardized test 02 engineering and technology Health records Research and Applications Clinical decision support system Medical Order Entry Systems World Wide Web 03 medical and health sciences 0302 clinical medicine Health care 0202 electrical engineering electronic engineering information engineering Medicine Humans Drug Interactions 030212 general & internal medicine Protocol (science) business.industry medicine.disease United States 3. Good health electronic health records Data Display Medical emergency business |
| Zdroj: | Journal of the American Medical Informatics Association : JAMIA |
| ISSN: | 1527-974X |
| Popis: | Objective: The United States Office of the National Coordinator for Health Information Technology sponsored the development of a “high-priority” list of drug-drug interactions (DDIs) to be used for clinical decision support. We assessed current adoption of this list and current alerting practice for these DDIs with regard to alert implementation (presence or absence of an alert) and display (alert appearance as interruptive or passive).Materials and methods: We conducted evaluations of electronic health records (EHRs) at a convenience sample of health care organizations across the United States using a standardized testing protocol with simulated orders.Results: Evaluations of 19 systems were conducted at 13 sites using 14 different EHRs. Across systems, 69% of the high-priority DDI pairs produced alerts. Implementation and display of the DDI alerts tested varied between systems, even when the same EHR vendor was used. Across the drug pairs evaluated, implementation and display of DDI alerts differed, ranging from 27% (4/15) to 93% (14/15) implementation.Discussion: Currently, there is no standard of care covering which DDI alerts to implement or how to display them to providers. Opportunities to improve DDI alerting include using differential displays based on DDI severity, establishing improved lists of clinically significant DDIs, and thoroughly reviewing organizational implementation decisions regarding DDIs.Conclusion: DDI alerting is clinically important but not standardized. There is significant room for improvement and standardization around evidence-based DDIs. |
| Databáze: | OpenAIRE |
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