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Related Experiment Videos

Implementing a commercial rule base as a medication order safety net.

Richard M Reichley1, Terry L Seaton, Ervina Resetar

  • 1Center for Healthcare Quality and Effectiveness, BJC Healthcare and Department of Medicine, Washington University School of Medicine, USA. rmr9716@bjc.org

Journal of the American Medical Informatics Association : JAMIA
|April 2, 2005
PubMed
Summary

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Customizing a commercial drug safety system significantly reduced alerts for excessive medication dosages. This enhanced clinical decision support, leading to fewer alerts and improved physician response to critical safety issues.

Area of Science:

  • Health Informatics
  • Clinical Pharmacology
  • Patient Safety

Background:

  • Commercial rule bases are used for medication safety.
  • Initial alert rates can be high, leading to alert fatigue.

Purpose of the Study:

  • To evaluate the impact of customizing a commercial rule base on alert rates and clinical utility.
  • To assess the effectiveness of a customized drug dosage safety net.

Main Methods:

  • A commercial rule base (Cerner Multum) was implemented and customized.
  • Alert rates were monitored before and after customization.
  • Clinical pharmacists screened alerts and communicated with ordering physicians.

Main Results:

  • Initial alert rate of 9.2% was reduced to less than 1% after customization.

Related Experiment Videos

  • Pharmacists reviewed alerts, leading to physician contact in 21% of cases.
  • Physicians made therapeutic changes in 38% of presented alerts.

    • Conclusions:

    • Customizing commercial rule bases effectively reduces alert burden.
    • This approach enhances drug dosage safety screening and clinical decision support.
    • Simple customization techniques enable rapid deployment of medication safety nets.