ArticleApplied clinical informatics2018
Determining Inappropriate Medication Alerts from "Inaccurate Warning" Overrides in the Intensive Care Unit.
Article in Applied clinical informatics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Interprofessional Evaluation of a Medication Clinical Decision Support System Prior to Implementation.Applied clinical informatics · 2024Article
- Facilitators and Barriers to Interacting With Clinical Decision Support in the ICU: A Mixed-Methods Approach.Critical care explorations · 2023Article
- Meaningless Use: Assessing Compliance With a Clinically Meaningless Emergency Department Documentation Requirement.Cureus · 2023Article
- Article
- Appropriateness of Alerts and Physicians' Responses With a Medication-Related Clinical Decision Support System: Retrospective Observational Study.JMIR medical informatics · 2022Article
- Physician Knowledge Base: Clinical Decision Support Systems.Yonsei medical journal · 2022Review
- Repurposing Clinical Decision Support System Data to Measure Dosing Errors and Clinician-Level Quality of Care.Journal of medical systems · 2020Article
- Appropriateness of Overridden Alerts in Computerized Physician Order Entry: Systematic Review.JMIR medical informatics · 2020Review
- Impact of Patient Census and Admission Mortality on Pediatric Intensive Care Unit Attending Electronic Health Record Activity: A Preliminary Study.Applied clinical informatics · 2020Article
- The Effect of Eliminating Intermediate Severity Drug-Drug Interaction Alerts on Overall Medication Alert Burden and Acceptance Rate.Applied clinical informatics · 2019Article
- Evaluating the Impact of Interruptive Alerts within a Health System: Use, Response Time, and Cumulative Time Burden.Applied clinical informatics · 2019Article
- Differences, Opportunities, and Strategies in Drug Alert Optimization-Experiences of Two Different Integrated Health Care Systems.Applied clinical informatics · 2019Article
- Structured override reasons for drug-drug interaction alerts in electronic health records.Journal of the American Medical Informatics Association : JAMIA · 2019Article
- Physicians Voluntarily Using an EHR-Based CDS Tool Improved Patients' Guideline-Related Statin Prescription Rates: A Retrospective Cohort Study.Applied clinical informatics · 2019Article
- Evaluation of Harm Associated with High Dose-Range Clinical Decision Support Overrides in the Intensive Care Unit.Drug safety · 2019Observational
- Diffusing an Innovation: Clinician Perceptions of Continuous Predictive Analytics Monitoring in Intensive Care.Applied clinical informatics · 2019Article
- Assessing the Safety of Custom Web-Based Clinical Decision Support Systems in Electronic Health Records: A Case Study.Applied clinical informatics · 2019Article
- Understanding Health Information Technology Induced Medication Safety Events by Two Conceptual Frameworks.Applied clinical informatics · 2019Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis article aims to understand provider behavior around the use of the override reason "Inaccurate warning," specifically whether it is an effective way of identifying unhelpful medication alerts. MATERIALS AND
methodsWe analyzed alert overrides that occurred in the intensive care units (ICUs) of a major academic medical center between June and November 2016, focused on the following high-significance alert types: dose, drug-allergy alerts, and drug-drug interactions (DDI). Override appropriateness was analyzed by two independent reviewers using predetermined criteria.
resultsA total of 268 of 26,501 ICU overrides (1.0%) used the reason "Inaccurate warning," with 93 of these overrides associated with our included alert types. Sixty-one of these overrides (66%) were identified to be appropriate. Twenty-one of 30 (70%) dose alert overrides were appropriate. Forty of 48 drug-allergy alert overrides (83%) were appropriate, for reasons ranging from prior tolerance (
conclusionThe "Inaccurate warning" reason was selectively used by a small proportion of providers and overrides using this reason identified important opportunities to reduce excess alerts. Potential opportunities include improved evaluation of dosing mechanisms based on patient characteristics, inclusion of institutional dosing protocols to alert logic, and evaluation of a patient's prior tolerance to a medication that they have a documented allergy for. This resource is not yet routinely used for alert tailoring at our institution but may prove to be a valuable resource to evaluate available alerts.
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