Development of a context model to prioritize drug safety alerts in CPOE systems

BMC Medical Informatics and Decision Making

Research Article

Wolf Stühlinger¹  Heleen van der Sijs²  Daniel Riedmann³  Elske Ammenwerth³  Martin Jung³  Werner O Hackl³ 

[1] Department for Public Health and HTA, UMIT - University for Health Sciences, Medical Informatics and Technology, Eduard Wallnöfer-Zentrum I, Hall in Tirol, Austria;Department of Hospital Pharmacy, Erasmus University Medical Centre, P.O. Box 2040, 3000, Rotterdam, CA, The Netherlands;Institute of Health Informatics, UMIT - University for Health Sciences, Medical Informatics and Technology, Eduard Wallnöfer-Zentrum I, Hall in Tirol, Austria;

关键词: Context Factor;    Medication Error;    Context Model;    Clinical Decision Support;    Clinical Decision Support System;   

DOI  :  10.1186/1472-6947-11-35

 received in 2011-02-04, accepted in 2011-05-25,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundComputerized physician order entry systems (CPOE) can reduce the number of medication errors and adverse drug events (ADEs) in healthcare institutions. Unfortunately, they tend to produce a large number of partly irrelevant alerts, in turn leading to alert overload and causing alert fatigue. The objective of this work is to identify factors that can be used to prioritize and present alerts depending on the 'context' of a clinical situation.MethodsWe used a combination of literature searches and expert interviews to identify and validate the possible context factors. The internal validation of the context factors was performed by calculating the inter-rater agreement of two researcher's classification of 33 relevant articles.ResultsWe developed a context model containing 20 factors. We grouped these context factors into three categories: characteristics of the patient or case (e.g. clinical status of the patient); characteristics of the organizational unit or user (e.g. professional experience of the user); and alert characteristics (e.g. severity of the effect). The internal validation resulted in nearly perfect agreement (Cohen's Kappa value of 0.97).ConclusionTo our knowledge, this is the first structured attempt to develop a comprehensive context model for prioritizing drug safety alerts in CPOE systems. The outcome of this work can be used to develop future tailored drug safety alerting in CPOE systems.

【 授权许可】

Unknown   
© Riedmann et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.