ArticleJournal of medical Internet research2020
A Late Attempt to Involve End Users in the Design of Medication-Related Alerts: Survey Study.
Article in Journal of medical Internet research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Optimizing clinical decision support alerts in electronic medical records: a systematic review of reported strategies adopted by hospitals.Journal of the American Medical Informatics Association : JAMIA · 2021Pooled it
- Duplicate Prescription Patterns in Patients With Substance Use Disorders.Pharmacology research & perspectives · 2026Article
- 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
- Article
- Clinician perspectives and recommendations regarding design of clinical prediction models for deteriorating patients in acute care.BMC medical informatics and decision making · 2024Article
- Optimizing Best Practice Advisory alerts in electronic medical records with a multi-pronged strategy at a tertiary care hospital in Singapore.JAMIA open · 2023Article
- An Ontology-Based Approach to Improving Medication Appropriateness in Older Patients: Algorithm Development and Validation Study.JMIR medical informatics · 2023Article
- Electronic Health Records That Support Health Professional Reflective Practice: a Missed Opportunity in Digital Health.Journal of healthcare informatics research · 2022Article
- OntoPharma: ontology based clinical decision support system to reduce medication prescribing errors.BMC medical informatics and decision making · 2022Article
- A Time and Motion Analysis of Nursing Workload and Electronic Health Record Use in the Emergency Department.Journal of emergency nursing · 2021Observational
- Fentanyl Quality Assurance Project Prompted Change in Clinical Workflow and Test Configurations.The journal of applied laboratory medicine · 2021Article
- Approaches Based on Artificial Intelligence and the Internet of Intelligent Things to Prevent the Spread of COVID-19: Scoping Review.Journal of medical Internet research · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhen users of electronic medical records (EMRs) are presented with large numbers of irrelevant computerized alerts, they experience alert fatigue, begin to ignore alert information, and override alerts without processing or heeding alert recommendations. Anecdotally, doctors at our study site were dissatisfied with the medication-related alerts being generated, both in terms of volume being experienced and clinical relevance.
objectiveThis study aimed to involve end users in the redesign of medication-related alerts in a hospital EMR, 4 years post implementation.
methodsThis work was undertaken at a private not-for-profit teaching hospital in Sydney, Australia. Since EMR implementation in 2015, the organization elected to implement all medication-related alert types available in the system for prescribers: allergy and intolerance alerts, therapeutic duplication alerts, pregnancy alerts, and drug-drug interaction alerts. The EMR included no medication administration alerts for nurses. To obtain feedback on current alerts and suggestions for redesign, a Web-based survey was distributed to all doctors and nurses at the site via hospital mailing lists.
resultsDespite a general dissatisfaction with alerts, very few end users completed the survey. In total, only 3.37% (36/1066) of doctors and 14.5% (60/411) of nurses took part. Approximately 90% (30/33) of doctors who responded held the view that too many alerts were triggered in the EMR. Doctors suggested that most alerts be removed and that alerts be more specific and less sensitive. In contrast, 97% (58/60) of the nurse respondents indicated that they would like to receive medication administration alerts in the EMR. Most nurses indicated that they would like to receive all the alert types available at all severity levels.
conclusionsAttempting to engage with end users several years post implementation was challenging. Involving users so late in the implementation process may lead to clinicians viewing the provision of feedback to be futile. Seeking user feedback on usefulness, volume, and design of alerts is extremely valuable; however, we suggest this is undertaken early, preferably before system implementation.
Indexed as
Identifiers
What OpenQuestion holds
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.