The emergence of universal electronic prescribing and content knowledge vendors has laid the groundwork for incorporating indications into the CPOE prescribing process. As medication prescribing moves in the direction of inclusion of the indication, it is imperative to design CPOE systems to efficiently and effectively incorporate indications into prescriber workflows and optimize ways this can best be accomplished.

The screening system was able to generate alerts that might otherwise be missed with existing CDS systems and did so with a reasonably high degree of alert usefulness when subjected to review of patients' clinical contexts and details.

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Key Points Question Is a redesigned electronic prescribing workflow to better support the incorporation of the indication in the outpatient prescribing process associated with reduced errors and improved clinician experience? Findings This quality improvement study compared an indications-based electronic prescribing prototype with that of 2 leading electronic health record vendors and found that the usability of the prototype system substantially outperformed both vendors’ prescribing systems in terms of efficiency, error rate, and satisfaction. Meaning Reengineering prescribing to start with the drug indication allowed indications to be captured in an easy and useful way and may be associated with saved time and effort, reduced errors, and increased clinician satisfaction.

Many spotlights currently illuminate the challenges associated with medical diagnosis. The National Academy of Medicine estimates that all patients will experience 1 serious diagnostic error during their lifetime, and diagnostic errors are now the leading cause of medical malpractice claims (1, 2). To avoid missing diagnoses, clinicians often order imaging and/or laboratory studies and initiate specialist referrals. However, physicians and patients are also urged to use fewer tests; nearly every U.S. medical specialty and 20 countries worldwide have initiated Choosing Wisely campaigns (3). Evidence increasingly shows that indiscriminate diagnostic testing and referrals often fail to provide definitive explanations or improve outcomes and at times are more harmful than beneficial.Balancing underdiagnosis (missing or delaying important diagnoses) and wasteful, harmful overdiagnosis (labeling patients with diseases that may never cause suffering or death) is often portrayed as the need "to keep the pendulum from swinging too far in either direction" (4).Rather than framing the problem as a simple, linear tradeoff, we believe it must be more fundamentally conceptualized as 2 sides of the same coin unified by the need for more cautious and careful approaches.