处方实时福利工具:临床医生经常收到警报,但很少接受建议的变化
Ishani Ganguli1, Nicholas E Daley2, Mark J Soto3
1Ishani Ganguli (iganguli@bwh.harvard.edu), Brigham and Women's Hospital and Harvard University, Boston, Massachusetts.
Health affairs (Project Hope)
|February 2, 2026
概括
在电子健康记录 (EHR) 中使用实时福利工具的临床医生经常根据警报更改处方. 然而,他们很少接受建议的替代方案,表明需要改进工具设计和可用性.
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
- 医疗保健服务研究 医疗服务研究
背景情况:
- 电子健康记录 (EHR) 越来越多地包含实时福利工具.
- 这些工具旨在通过提供价格信息和替代品来提高药物负担能力和药物坚持.
- 临床医生的参与对于这些工具的成功至关重要,但它仍未得到充分研究.
研究的目的:
- 检查临床医生的参与与实时效益工具在EHRs.
- 分析临床医生如何响应药品价格警报和建议的替代品.
- 确定影响这些工具在临床实践中的有效性的因素.
主要方法:
- 来自803家门诊诊所和4894名临床医生 (2019-2022) 的EHR数据的分析.
- 对警报频率,临床医生的响应率和订单修改类型的量化.
- 通过不同临床专业的警报参与的比较.
主要成果:
- 临床医生平均每100个订单收到19个警报,87%收到至少一个警报.
- 91%收到警报的临床医生至少修改了一次订单.
- 针对所有警报的11%进行了变化,最常涉及药店 (60%) 或数量 (39%),很少涉及药物本身 (4%).
- 主要护理临床医生收到了最多的警报,而小专家对更大比例的警报进行了更改.
结论:
- 临床医生通过修改订单,积极参与实时福利工具,但很少接受建议的替代方案.
- 成功实施需要解决警报质量,可用性,时间负担和警报疲劳.
- 进一步的研究应该集中在优化这些工具,以更好地支持临床医生和改善患者的结果.
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