Cited by 353Electronic Health Records SystemsPatient Safety and Medication ErrorsPharmaceutical Practices and Patient Outcomes

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Improving Acceptance of Computerized Prescribing Alerts in Ambulatory Care

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Shah, Nidhi R., Seger, Andrew C., Seger, Diane L., Fiskio, Julie M., Kuperman, Gilad J., Blumenfeld, Barry, Recklet, Elaine G., Bates, David W., Gandhi, Tejal K.·2006·Journal of the American Medical Informatics Association

DOI 10.1197/jamia.m1868PMC PMC1380196

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Abstract

Computerized drug prescribing alerts can improve patient safety, but are often overridden because of poor specificity and alert overload. Our objective was to improve clinician acceptance of drug alerts by designing a selective set of drug alerts for the ambulatory care setting and minimizing workflow disruptions by designating only critical to high-severity alerts to be interruptive to clinician workflow. The alerts were presented to clinicians using computerized prescribing within an electronic medical record in 31 Boston-area practices. There were 18,115 drug alerts generated during our six-month study period. Of these, 12,933 (71%) were noninterruptive and 5,182 (29%) interruptive. Of the 5,182 interruptive alerts, 67% were accepted. Reasons for overrides varied for each drug alert category and provided potentially useful information for future alert improvement. These data suggest that it is possible to design computerized prescribing decision support with high rates of alert recommendation acceptance by clinicians.

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Authors: Shah, N. R., Seger, A. C., Seger, D. L., Fiskio, J. M., Kuperman, G. J., Blumenfeld, B., Recklet, E. G., Bates, D. W., & Gandhi, T. K.
Affiliations: Brigham and Women's Hospital (US)
Corresponding author: Gandhi, Tejal K.
ORCID: Shah, Nidhi R.
Seger, Diane L.
Kuperman, Gilad J.
Blumenfeld, Barry
Bates, David W.
Venue: Journal of the American Medical Informatics Association
Publisher: Oxford University Press (OUP)
Published: 2006-01
Volume: 13
Issue: 1
Pages: 5-11
ISSN: 1067-5027 (ISSN-L)
1527-974X
DOI: 10.1197/jamia.m1868
PMC: PMC1380196
OpenAlex: W2131675703
Cited by: 353
References: 22
Citations by year: 2026: 2 · 2025: 5 · 2024: 6 · 2023: 9 · 2022: 14 · 2021: 14 · 2020: 7 · 2019: 12 · 2018: 8 · 2017: 16 · 2016: 23 · 2015: 25 · 2014: 24 · 2013: 32 · 2012: 40
FWCI: 22.35
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Journal of the American Medical Informatics Association (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Agency for Healthcare Research and Quality (2t32hs000020-18, R01-HS1169)
Topics: Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
Keywords: drug alerts, alert override, clinician acceptance, interruptive alerts, electronic health records, outpatient care, patient safety, workflow disruption
MeSH terms: Contraindications, Adult, Ambulatory Care Information Systems, Attitude of Health Personnel, Attitude to Computers, Drug Therapy, Computer-Assisted, Pharmaceutical Preparations, Female, Humans, Medication Errors, Pregnancy, Drug Prescriptions, Primary Health Care, User-Computer Interface, Medical Records Systems, Computerized, Reminder Systems, Medical Order Entry Systems

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Improving Acceptance of Computerized Prescribing Alerts in Ambulatory Care

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