ArticleInternational journal of medical informatics2018
Best practices for preventing malfunctions in rule-based clinical decision support alerts and reminders: Results of a Delphi study.
Article in International journal of medical informatics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Optimizing Clinical Decision Support System Functionality by Leveraging Specific Human-Computer Interaction Elements: Insights From a Systematic Review.JMIR human factors · 2025Pooled it
- Expanding access to veterinary clinical decision support in resource-limited settings: a scoping review of clinical decision support tools in medicine and antimicrobial stewardship.Frontiers in veterinary science · 2024Article
- Ontologies Applied in Clinical Decision Support System Rules: Systematic Review.JMIR medical informatics · 2023Review
- Implementation of Machine Learning Pipelines for Clinical Practice: Development and Validation Study.JMIR medical informatics · 2022Article
- Clinical decision support malfunctions related to medication routes: a case series.Journal of the American Medical Informatics Association : JAMIA · 2022Article
- Real-Time User Feedback to Support Clinical Decision Support System Improvement.Applied clinical informatics · 2022Article
- Clinician collaboration to improve clinical decision support: the Clickbusters initiative.Journal of the American Medical Informatics Association : JAMIA · 2022Article
- Clinical Decision Support Stewardship: Best Practices and Techniques to Monitor and Improve Interruptive Alerts.Applied clinical informatics · 2022Review
- A qualitative study of prescribing errors among multi-professional prescribers within an e-prescribing system.International journal of clinical pharmacy · 2021Article
- Recommendations for the safe, effective use of adaptive CDS in the US healthcare system: an AMIA position paper.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Giving Your Electronic Health Record a Checkup After COVID-19: A Practical Framework for Reviewing Clinical Decision Support in Light of the Telemedicine Expansion.JMIR medical informatics · 2021Article
- Algorithmic Detection of Boolean Logic Errors in Clinical Decision Support Statements.Applied clinical informatics · 2021Article
- EHRtemporalVariability: delineating temporal data-set shifts in electronic health records.GigaScience · 2020Article
- Reducing Alert Burden in Electronic Health Records: State of the Art Recommendations from Four Health Systems.Applied clinical informatics · 2020Article
- How to Develop and Implement a Computerized Decision Support System Integrated for Antimicrobial Stewardship? Experiences From Two Swiss Hospital Systems.Frontiers in digital health · 2020Article
- Structured override reasons for drug-drug interaction alerts in electronic health records.Journal of the American Medical Informatics Association : JAMIA · 2019Article
- Impact of a Clinical Decision Support Alert on Informed Consent Documentation in the Neonatal Intensive Care Unit.Pediatric quality & safetyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
objectiveDeveloping effective and reliable rule-based clinical decision support (CDS) alerts and reminders is challenging. Using a previously developed taxonomy for alert malfunctions, we identified best practices for developing, testing, implementing, and maintaining alerts and avoiding malfunctions. MATERIALS AND
methodsWe identified 72 initial practices from the literature, interviews with subject matter experts, and prior research. To refine, enrich, and prioritize the list of practices, we used the Delphi method with two rounds of consensus-building and refinement. We used a larger than normal panel of experts to include a wide representation of CDS subject matter experts from various disciplines.
results28 experts completed Round 1 and 25 completed Round 2. Round 1 narrowed the list to 47 best practices in 7 categories: knowledge management, designing and specifying, building, testing, deployment, monitoring and feedback, and people and governance. Round 2 developed consensus on the importance and feasibility of each best practice. DISCUSSION: The Delphi panel identified a range of best practices that may help to improve implementation of rule-based CDS and avert malfunctions. Due to limitations on resources and personnel, not everyone can implement all best practices. The most robust processes require investing in a data warehouse. Experts also pointed to the issue of shared responsibility between the healthcare organization and the electronic health record vendor.
conclusionThese 47 best practices represent an ideal situation. The research identifies the balance between importance and difficulty, highlights the challenges faced by organizations seeking to implement CDS, and describes several opportunities for future research to reduce alert malfunctions.
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Registered trials
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.