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Author Spotlight: Developing a Point-of-Care Hemoglobin Estimation Method for Anemia Management

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Improving medication-related clinical decision support.

Clare L Tolley¹, Sarah P Slight^2,3, Andrew K Husband⁴

¹Institute of Health and Society, Sir James Spence Institute, Newcastle University, Newcastle upon Tyne, United Kingdom, United Kingdom.

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists

|February 14, 2018

Summary

This summary is machine-generated.

Medication-related clinical decision support (CDS) systems need improvement for better alert value and actionability. Enhancing specificity, integrating patient data, and considering human factors are key to optimizing CDS effectiveness.

Keywords:

clinical decision support systems decision-making electronic prescribing medical order entry systems medication errors patient safety

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Area of Science:

Health Informatics
Clinical Pharmacy
Medical Decision Support

Background:

Medication-related clinical decision support (CDS) systems are crucial for safe medication use.
Current systems face challenges in alert value and user actionability.
Optimizing CDS requires addressing system limitations and enhancing user experience.

Purpose of the Study:

To review current uses of medication-related CDS.
To identify recommendations for improving these systems.
To analyze the effectiveness of 5 core CDS functionalities.

Main Methods:

Systematic review of articles from MEDLINE and EMBASE (2007-2014).
Keywords focused on 5 medication-related CDS functionalities: drug-drug interaction (DDI) checks, drug allergy checks, drug dose support, drug duplication checks, and drug formulary support.
Analysis of 156 full-text articles and 28 conference abstracts.

Main Results:

Success hinges on users finding alerts valuable and acting on them.
Improving alert specificity and sensitivity is crucial across all CDS domains.
Specific improvements include tiering for DDI alerts, cross-sensitivity for allergy checks, individualized dosing, toxicity prevention for duplication checks, and accurate databases for formulary support.

Conclusions:

Medication-related CDS is immature in many organizations, with significant room for enhancement.
Integrating patient-specific factors and human factors principles is essential.
Standardization and improved alert specificity are vital for realizing CDS potential and reducing alert fatigue.