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)... ... June 27, 2016 , ... ... professionals, announced today its affiliation with Tennessee Counseling Association. This new ... network of the Tennessee Counseling Association, adding exclusive benefits and promotional offers. , ...
(Date:6/27/2016)... KS (PRWEB) , ... June 27, 2016 , ... TopConsumerReviews.com ... retailers of Eyeglasses . , Millions of individuals in the United States and ... have become a way to both correct vision and make a fashion statement. Even ...
(Date:6/26/2016)... ... June 26, 2016 , ... Pixel Film Studios Released ... , "Film editors can give their videos a whole new perspective by using the ... CEO of Pixel Film Studios. , ProSlice Levels contains over 30 Different presets ...
(Date:6/26/2016)... ... June 26, 2016 , ... Many ... been diagnosed with endometriosis. These women need a treatment plan to not only ... approach that can help for preservation of fertility and ultimately achieving a pregnancy. ...
(Date:6/25/2016)... ... ... Bruton Memorial Library on June 21 due to a possible lice infestation, as reported by ... lice: the parasite’s ability to live away from a human host, and to infest common ... the event that lice have simply gotten out of control. , As lice are a ...
Breaking Medicine News(10 mins):
(Date:6/26/2016)... , June 27, 2016  VMS Rehab Systems, Inc. ... will take whatever measures required to build a strong ... which is currently listed on the OTC Markets-pink current ... Chairman and CEO, "We are seeing an anomaly in ... understand, not only by the Company, but shareholders and ...
(Date:6/24/2016)... Calif. , June 24, 2016  Global ... a biopharmaceutical company developing novel therapeutics for the ... needs, today announced the closing of its previously ... common stock, at the public offering price of ... the offering were offered by GBT. GBT estimates ...
(Date:6/24/2016)... , June 24, 2016 The Academy of ... recommendations that would allow biopharmaceutical companies to ... entities that make formulary and coverage decisions, a move ... of new medicines. The recommendations address restrictions ... appear on the drug label, a prohibition that hinders ...
Breaking Medicine Technology: