Navigation Links
Clinicians override most electronic medication safety alerts
Date:2/10/2009

BOSTON--Computer-based systems that allow clinicians to prescribe drugs electronically are designed to automatically warn of potential medication errors, but a new study reveals clinicians often override the alerts and rely instead on their own judgment.

The study, led by investigators at Dana-Farber Cancer Institute and Beth Israel Deaconess Medical Center (BIDMC), suggests that most clinicians find the current medication alerts more of an annoyance than a valuable tool. The authors conclude that if electronic prescribing is to effectively enhance patient safety, significant improvements are necessary. The study's findings appear in the Feb. 9 issue of the Archives of Internal Medicine.

"Electronic prescribing clearly will improve medication safety, but its full benefit will not be realized without the development and integration of high-quality decision support systems to help clinicians better manage medication safety alerts," says the study's senior author Saul Weingart, MD, PhD, vice president for patient safety at Dana-Farber and an internist at BIDMC.

The researchers reviewed the electronic prescriptions and associated medication safety alerts generated by 2,872 clinicians at community-based outpatient practices in Massachusetts, New Jersey, and Pennsylvania to learn how clinicians responded to the alerts.

The clinicians submitted 3.5 million electronic prescriptions between Jan. 1, and Sept. 30, 2006. Approximately one in 15 prescription orders, or 6.6 percent, produced an alert for a drug interaction or a drug allergy. The vast majority of the 233,537 alerts (98.6 percent) were for a potential interaction with a drug a patient already takes.

Clinicians overrode more than 90 percent of the drug interaction alerts and 77 percent of the drug allergy alerts. Even when a drug interaction alert was rated with high severity, clinicians typically dismissed those for medications commonly used in combination to treat specific diseases. They also were less likely to accept an alert if the patient had previously been treated with the medication.

The high override rate of all alerts, the researchers contend, suggests that the utility of electronic medication alerts is inadequate, adding that for some clinicians, most alerts "may be more of a nuisance than an asset."

"The sheer volume of alerts generated by electronic prescribing systems stands to limit the safety benefits," says Thomas Isaac, MD, MBA, MPH, of BIDMC and Dana-Farber and the paper's first author. "Too many alerts are generated for unlikely events, which could lead to alert fatigue. Better decision support programs will generate more pertinent alerts, making electronic prescribing more effective and safer."

Although the study analyzed orders generated on only one electronic prescribing system, PocketScript, the researchers say their observations are relevant to other systems because the alerts they reviewed were typical and were generated by a commercial database, Cerner Multum, used by other electronic prescribing systems.

Based on these findings, Weingart and his colleagues offer several recommendations to improve medication safety alerts, including reclassifying severity of alerts, especially those that are frequently overridden; providing an option for clinicians to suppress alerts for medications a patient already has received; and customizing the alerts for a clinician's specialty. The research team identified a list of potentially dangerous drug interactions based on those alerts that most often changed the clinicians' decision to prescribe. This list is available at www.dana-farber.org/electronic-medication-safety.

"We need to find a way to help clinicians to separate the proverbial wheat from the chaff," says Weingart. "Until then, electronic prescribing systems stand to fall far short of their promise to enhance patient safety and to generate greater efficiencies and cost savings."


'/>"/>

Contact: Bill Schaller
william_schaller@dfci.harvard.edu
617-632-5357
Dana-Farber Cancer Institute
Source:Eurekalert  

Related medicine news :

1. Practicing Clinicians Exchange Forms Partnership with CDC
2. Clinicians at Dartmouth-Hitchcock Medical Center Present New Data Showing Masimo Rainbow SET(R) Oximetry and Patient SafetyNet(TM) Improves Patient Outcomes and Reduces the Cost of Care
3. Video: Intel Announces its First Home Medical Device in the United Kingdom to Better Connect Clinicians With Patients
4. Election-Eve MedPage Today(R) Poll Gives Obama Double-Digit Lead Among Clinicians
5. Baptist Health System Deploys Sentillions Vergence Solution to Provide Secure Identity and Access Management to 3,000 Clinicians
6. Clinicians in Netherlands Treat Lung Cancer Patients Using New RapidArc Radiotherapy Technology from Varian Medical Systems
7. AHRQ Releases Two New Resources to Help Consumers and Clinicians Prevent Dangerous Blood Clots
8. Report says clinicians should consider economic impact of new interventions
9. APCTODAY.com and Convera(R) Launch Vertical Search Site for Advanced Practice Clinicians
10. Streamline Healths Document Management Solution Integrated into Oacis, Allowing Clinicians to Access Patients Information - Either Scanned or Electronic
11. CME Publication Gives Clinicians a Leg Up in Treating Disorders of the Lower Extremities
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Clinicians override most electronic medication safety alerts
(Date:6/27/2016)... ... 27, 2016 , ... TherapySites, the leading website ... Tennessee Counseling Association. This new relationship allows TherapySites to continue to ... adding exclusive benefits and promotional offers. , "TCA is extremely excited about this ...
(Date:6/26/2016)... ... June 26, 2016 , ... On June 10-11, 2016, A Forever Recovery, ... Festival and World’s Longest Breakfast Table in Battle Creek, MI, where the rehabilitation facility ... home to some of the world’s leading providers of cereal and other breakfast foods. ...
(Date:6/25/2016)... ... June 25, 2016 , ... ... issues and applications at AcademyHealth’s Annual Research Meeting June 26-28, 2016, at the ... several important health care topics including advance care planning, healthcare costs and patient ...
(Date:6/25/2016)... , ... June 25, 2016 , ... As a lifelong ... Cum Laude and his M.D from the David Geffen School of Medicine at UCLA. ... to Los Angeles to complete his fellowship in hematology/oncology at the UCLA-Olive View-Cedars Sinai ...
(Date:6/24/2016)... Marne, Michigan (PRWEB) , ... June 24, 2016 , ... ... To deal with these feelings, many turn to unhealthy avenues, such as drug or ... Center of Marne, Michigan, has released tools for healthy coping following a traumatic event. ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... -- The vast majority of dialysis patients currently receive ... usually 3 times a week, with treatment times averaging ... equipment preparation and wait time.  This regimen can be ... who are elderly and frail.  Many elderly dialysis patients ... for some duration of time. Residents in ...
(Date:6/23/2016)... 23, 2016  Experian Health, the healthcare ... the patient payment and care experience, today ... products and services that will enhance the ... offerings. These award-winning solutions will enable healthcare ... compliant in an ever-changing environment and redefine ...
(Date:6/23/2016)... -- The National Pharmaceutical Council (NPC) today announced that ... organization as its newest member.  ... and chief scientific officer, Mallinckrodt Pharmaceuticals, will serve ... of Directors. ... in support of our efforts to conduct research ...
Breaking Medicine Technology: