关于CDS故障的专题:基于电子健康记录的警报的演变,以优化静脉血栓塞栓症的预防
Mikhail Y Akbashev1,2, Alyssa Utz3, Phillip Luis Anjum1,2
1Medicine, Emory University School of Medicine, Atlanta, United States.
Applied clinical informatics
|July 31, 2025
概括
优化电子健康记录警报 (EHRA) 用于静脉血栓塞栓症 (VTE) 预防在住院患者的警报频率减少3倍,同时增加提供者的参与32倍. 精心设计是平衡VTE预防和警觉疲劳的关键.
科学领域:
- 医疗信息学 医疗信息学
- 临床决策支持 临床决策支持
- 患者安全 患者安全
背景情况:
- 在住院患者的静脉血栓塞栓症 (VTE) 预防中,平衡出血和血栓形成风险至关重要.
- 临床事件可能会干扰静脉瘤预防,需要有效的提供者通知.
- 电子健康记录警报 (EHRA) 可以改善静脉瘤预防,但如果设计不佳,则可能导致警报疲劳.
研究的目的:
- 开发和完善一个EHRA以尽量减少麻烦警报.
- 为医疗患者提供适当的VTE预防.
- 改善VTE预防的交付,同时降低提供者的负担.
主要方法:
- 一个多学科团队在四个阶段中开发和完善了EHRA.
- 欧洲卫生药物管理局确定了缺乏VTE预防的风险患者.
- 数据分析的重点是警报频率,利用率和持续时间.
主要成果:
- 最初的EHRA实施显著增加了警报频率和患者警报.
- 在第二阶段和第三阶段的后续修改并没有改善提供者的行动.
- 第四阶段的修改大大减少了警报频率,并增加了提供者的行动.
结论:
- 一个以提供者为中心的干预措施改善了EHRA的设计和提供者参与.
- 经过改进的EHRA实现了警报频率下降3倍,提供商参与度增加32倍.
- 持续的监测和维护对于持续的EHRA有效性至关重要.
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