ArticleJournal of the American Medical Informatics Association : JAMIA
The influence of computerized decision support on prescribing during ward-rounds: are the decision-makers targeted?
Article in Journal of the American Medical Informatics Association : JAMIA. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
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Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 70 citations in OpenAlex.
- From interface to outcome: a 4I framework for AI-linked functionality in electronic health records.BMC medical informatics and decision making · 2026Pooled it
- How do stakeholders experience the adoption of electronic prescribing systems in hospitals? A systematic review and thematic synthesis of qualitative studies.BMJ quality & safety · 2019Pooled it
- Usability Flaws in Medication Alerting Systems: Impact on Usage and Work System.Yearbook of medical informatics · 2015Pooled it
- Factors Affecting Prescriber Implementation of Computer-Generated Medication Recommendations in the SENATOR Trial: A Qualitative Study.Drugs & aging · 2020Trial
- Effectiveness of computerised alerts to reduce drug-drug interactions (DDIs) and DDI-related harm in hospitalised patients: a quasi-experimental controlled pre-post study.BMJ quality & safety · 2025Article
- Using shared clinical decision support to reduce adverse drug events and improve patient safety.Frontiers in digital health · 2025Review
- Alerts in Clinical Decision Support Systems (CDSS): A Bibliometric Review and Content Analysis.Healthcare (Basel, Switzerland) · 2022Article
- Habit and Automaticity in Medical Alert Override: Cohort Study.Journal of medical Internet research · 2022Article
- Challenges and Best Practices in Ethical Review of Human and Organizational Factors Studies in Health Technology: a Synthesis of Testimonies.Yearbook of medical informatics · 2020Article
- A Late Attempt to Involve End Users in the Design of Medication-Related Alerts: Survey Study.Journal of medical Internet research · 2020Article
- Mixed methods study of medication-related decision support alerts experienced during electronic prescribing for inpatients at an English hospital.European journal of hospital pharmacy : science and practice · 2019Article
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- Reliability, ease of use and usefulness of I-MeDeSA for evaluating drug-drug interaction alerts in an Australian context.BMC medical informatics and decision making · 2018Article
- Use of a Novel, Electronic Health Record-Centered, Interprofessional ICU Rounding Simulation to Understand Latent Safety Issues.Critical care medicine · 2018Article
- Evidence-based usability design principles for medication alerting systems.BMC medical informatics and decision making · 2018Article
- Redesign of computerized decision support to improve antimicrobial prescribing. A controlled before-and-after study.Applied clinical informatics · 2017Article
- Cardiovascular care guideline implementation in community health centers in Oregon: a mixed-methods analysis of real-world barriers and challenges.BMC health services research · 2017Article
- Alert override as a habitual behavior - a new perspective on a persistent problem.Journal of the American Medical Informatics Association : JAMIA · 2017Article
- A multifaceted intervention to reduce drug-related complications in surgical patients.British journal of clinical pharmacology · 2017Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess whether a low level of decision support within a hospital computerized provider order entry system has an observable influence on the medication ordering process on ward-rounds and to assess prescribers' views of the decision support features.
methods14 specialty teams (46 doctors) were shadowed by the investigator while on their ward-rounds and 16 prescribers from these teams were interviewed.
resultsSenior doctors were highly influential in prescribing decisions during ward-rounds but rarely used the computerized provider order entry system. Junior doctors entered the majority of medication orders into the system, nearly always ignored computerized alerts and never raised their occurrence with other doctors on ward-rounds. Interviews with doctors revealed that some decision support features were valued but most were not perceived to be useful. DISCUSSION AND
conclusionThe computerized alerts failed to target the doctors who were making the prescribing decisions on ward-rounds. Senior doctors were the decision makers, yet the junior doctors who used the system received the alerts. As a result, the alert information was generally ignored and not incorporated into the decision-making processes on ward-rounds. The greatest value of decision support in this setting may be in non-ward-round situations where senior doctors are less influential. Identifying how prescribing systems are used during different clinical activities can guide the design of decision support that effectively supports users in different situations. If confirmed, the findings reported here present a specific focus and user group for designers of medication decision support.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.