safety alert
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Epidemiology
- ~60% of automated notifications of actionable tests pending at hospital discharge with documented follow-up in the medical record[5]
Indications
- component of computerized provider order entry
- reduce medication errors
- improve adherence to recommended treatments
* yet to improve clinical outcomes
Complications
- alert fatigue[1]
- renal or age warnings often overlooked[1]
- alerts rendered meaningless by their sheer number[2]
- primary care physicians receive ~77 notifications daily[3]
- VAMC providers receive > 100 electronic alerts/day, each requiring ~ 85 seconds to address (> 2 hours/day)[4]
- electronic alerts to avoid cephalosporin use in patients with history of penicillin allergy reduces use of cephalosporins[6]
Additional terms
References
- ↑ 1.0 1.1 1.2 Nanji KC, Seger DL, Slight SP et al. J Am Med Inform Assoc. 2017 Oct 27; Medication-related clinical decision support alert overrides in inpatients. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29092059 https://psnet.ahrq.gov/resources/resource/31608
- ↑ 2.0 2.1 Rosenbaum L Transitional Chaos or Enduring Harm? The EHR and the Disruption of Medicine. N Engl J Med 2015; 373:1585-1588. October 22, 2015. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26488690 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMp1509961
- ↑ 3.0 3.1 Murphy DR, Meyer AN, Russo E The Burden of Inbox Notifications in Commercial Electronic Health Records. JAMA Intern Med. 2016 Apr 1;176(4):559-60. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26974737
- ↑ 4.0 4.1 Shah T, Patel-Teague S, Kroupa L, Meyer AND, Singh H. Impact of a national QI programme on reducing electronic health record notifications to clinicians. BMJ Qual Saf. 2018 Mar 5 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29507122 Free Article https://psnet.ahrq.gov/resources/resource/31968
- ↑ 5.0 5.1 Dalal AK, Schaffer A, Gershanik EF, et al. The impact of automated notification on follow-up of actionable tests pending at discharge: a cluster-randomized controlled trial. J Gen Intern Med. 2018 Mar 12; PMID: https://www.ncbi.nlm.nih.gov/pubmed/29532297 https://psnet.ahrq.gov/resources/resource/31998
- ↑ 6.0 6.1 Macy E et al. Association between removal of a warning against cephalosporin use in patients with penicillin allergy and antibiotic prescribing. JAMA Netw Open 2021 Apr 1; 4:e218367. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33914051 PMCID: PMC8085727 Free PMC article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2779305