Stakeholder Perspectives on an Inpatient Hypoglycemia Informatics Alert: Mixed Methods Study

Area of Science:

• Health Informatics
• Clinical Decision Support Systems
• Patient Safety

Background:

• Iatrogenic hypoglycemia is a frequent adverse event in hospitalized patients, linked to adverse outcomes and mortality.
• Clinical decision support systems offer a strategy to mitigate this preventable harm.

Purpose of the Study:

• To identify essential features and functionality for a real-time informatics alert aimed at preventing hospital-acquired hypoglycemia.
• To gather stakeholder input for developing an effective hypoglycemia alert system.

Main Methods:

• A mixed-methods approach utilizing electronic surveys and focus groups with hospital providers.
• Application of the Agency for Healthcare Research and Quality's Five Rights of Effective Clinical Decision Support Framework.
• Thematic analysis of qualitative data to understand provider preferences for alert content, format, timing, and recipients.

Main Results:

• 102 providers completed the survey; 12 participated in focus groups.
• Universal agreement on the importance of addressing inpatient iatrogenic hypoglycemia with informatics alerts.
• Preferred alert characteristics include non-intrusiveness, accuracy, near real-time delivery to the ordering provider, and actionable recommendations. Concerns about alert fatigue were common.

Conclusions:

• Identified design preferences will guide the development of a prototype alert for pilot testing.
• The developed alert aims to support clinicians in managing high-risk diabetic patients and preventing hypoglycemia.