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Cited by 72Electronic Health Records SystemsArtificial Intelligence in Healthcare and EducationTechnology and Human Factors in Education and Health

Effect of CPOE User Interface Design on User-Initiated Access to Educational and Patient Information during Clinical Care

Open access
Rosenbloom, S. Trent, Geissbuhler, Antoine J., Dupont, William D., Giuse, Dario A., Talbert, Douglas A., Tierney, William M., Plummer, W. Dale, Stead, William W. +1 more·2005·Journal of the American Medical Informatics Association
DOI 10.1197/jamia.m1627PMC PMC1174891
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Abstract

OBJECTIVE: Authors evaluated whether displaying context sensitive links to infrequently accessed educational materials and patient information via the user interface of an inpatient computerized care provider order entry (CPOE) system would affect access rates to the materials. DESIGN: The CPOE of Vanderbilt University Hospital (VUH) included "baseline" clinical decision support advice for safety and quality. Authors augmented this with seven new primarily educational decision support features. A prospective, randomized, controlled trial compared clinicians' utilization rates for the new materials via two interfaces. Control subjects could access study-related decision support from a menu in the standard CPOE interface. Intervention subjects received active notification when study-related decision support was available through context sensitive, visibly highlighted, selectable hyperlinks. MEASUREMENTS: Rates of opportunities to access and utilization of study-related decision support materials from April 1999 through March 2000 on seven VUH Internal Medicine wards. RESULTS: During 4,466 intervention subject-days, there were 240,504 (53.9/subject-day) opportunities for study-related decision support, while during 3,397 control subject-days, there were 178,235 (52.5/subject-day) opportunities for such decision support, respectively (p = 0.11). Individual intervention subjects accessed the decision support features at least once on 3.8% of subject-days logged on (278 responses); controls accessed it at least once on 0.6% of subject-days (18 responses), with a response rate ratio adjusted for decision support frequency of 9.17 (95% confidence interval 4.6-18, p < 0.0005). On average, intervention subjects accessed study-related decision support materials once every 16 days individually and once every 1.26 days in aggregate. CONCLUSION: Highlighting availability of context-sensitive educational materials and patient information through visible hyperlinks significantly increased utilization rates for study-related decision support when compared to "standard" VUH CPOE methods, although absolute response rates were low.

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  • Embedding clinical decision support within CPOE systems may increase clinician-users' access to educational material and may affect learning and retention.

    “Although limited experience exists, embedding clinical decision support (CDS) within CPOE systems may increase clinician-users' access to educational material 30,31 and may affect learning and retention.32”

    From Types of Unintended Consequences Related to Computerized Provider Order Entry (2006) · cites this paper as [30]

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  1. [31]31. Wyatt J. Use and sources of medical knowledge. Lancet. 1991; 338:1368-73.
  2. [70]70. Dean NC, Suchyta MR, Bateman KA, Aronsky D, Hadlock CJ. Implementation of admission decision support for communityacquired pneumonia. Chest. 2000;117:1368-77.
  3. [108]108. Stead WW, Bates RA, Byrd J, Giuse DA, Miller RA, Shultz EK. Case study: the Vanderbilt University Medical Center information management architecture. In: Van De Velde R, Degoulet P (eds). Clinical information systems: a component-based approach. New York: Springer-Verlag; 2003, Appendix C.
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Authors
Rosenbloom, S. T., Geissbuhler, A. J., Dupont, W. D., Giuse, D. A., Talbert, D. A., Tierney, W. M., Plummer, W. D., Stead, W. W., & Miller, R. A.
Affiliations
Regenstrief Institute (US)
Corresponding author
Rosenbloom, S. Trent
ORCID
Venue
Journal of the American Medical Informatics Association
Publisher
Oxford University Press (OUP)
Published
2005-07
Volume
12
Issue
4
Pages
458-473
ISSN
  • 1067-5027 (ISSN-L)
  • 1527-974X
DOI
10.1197/jamia.m1627
PMC
PMC1174891
OpenAlex
W2111040505
Cited by
71
References
121
Citations by year
2022: 6 · 2021: 1 · 2020: 1 · 2019: 3 · 2018: 2 · 2017: 1 · 2016: 3 · 2015: 3 · 2014: 5 · 2013: 4 · 2012: 2
FWCI
16.19
Type
journal article
Language
en
Open access
Locations
  • Journal of the American Medical Informatics Association (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • reroDoc Digital Library (submittedVersion)
Funders
  • National Institutes of Health (5r01lm006226-03)
  • U.S. National Library of Medicine (R01 LM06226-01, T15LM007450)
Topics
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
  • Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Technology and Human Factors in Education and Health
Keywords
computerized physician order entry, clinical decision support, educational decision support, patient data access, internal medicine ward
MeSH terms
Decision Making, Computer-Assisted, Hospital Information Systems, Hospitals, University, Humans, Tennessee, User-Computer Interface, Medical Records Systems, Computerized, Decision Support Systems, Clinical

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