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Feedback at the Point of Care to Decrease Medication Alert Rates in an Electronic Health Record.

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This summary is machine-generated.

Pediatric emergency providers can identify and revise problematic electronic health record medication alerts. This user-centered approach improves alert relevance and reduces disruptions in clinical decision support systems.

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Area of Science:

  • Clinical Informatics
  • Health Information Technology
  • Patient Safety

Background:

  • Electronic health record (EHR) alerts are crucial for clinical decision support but can be overridden frequently, indicating a need for refinement.
  • Overridden alerts suggest potential issues with alert accuracy, intrusiveness, or clinical relevance.

Purpose of the Study:

  • To evaluate a method for pediatric emergency department (PED) providers to identify and report problematic medication alerts.
  • To assess the impact of modifications made to alerts based on provider feedback on alert salience.

Main Methods:

  • A prospective, interventional study was conducted in a PED over 34 months.
  • A passive alert feedback mechanism was implemented within the EHR, allowing end-users to flag alerts for review.
  • Alert reviews were conducted, and clinically appropriate modifications were made, with impact trends evaluated.

Main Results:

  • Over 200 alerts were reported, indicating an intuitive feedback mechanism.
  • An average of 4 reviews were processed weekly, with attending physicians being primary contributors.
  • The modifications generally showed a favorable impact on alert trends.

Conclusions:

  • User-selected alert review mechanisms are intuitive, sustainable, and effective in identifying bothersome alerts.
  • This user-centered approach complements traditional data-driven methods for detecting inaccurate medication alerts.
  • Context-specific feedback is valuable for refining suboptimal and interruptive medication alerts.