Optimization of drug–drug interaction alert rules in a pediatric hospital's electronic health record system using a visual analytics dashboard

Abstract

An alert dashboard facilitated safe rapid-cycle reductions in alert burden that were temporally associated with lower pharmacist override rates in a subgroup of DDIs not directly affected by the interventions; meanwhile, the pharmacists' frequency of selecting the 'cancel' option increased. We hypothesize that reducing the alert burden enabled pharmacists to devote more attention to clinically relevant alerts.

Investigating Analytics Dashboards’ Support for the Value-based Healthcare Delivery Model

“…Source Primary care practitioner [40]- [42], [45], [47]- [49], [52] General Practitioner [34] Clinician [9], [17]- [21], [31], [46], [50], [55], [56], [58], [59] Physician [5], [35], [39], [42], [44], [53] Nurse [4], [33], [36], [38], [42], [50] Medical Staff [4], [6], [7], [19], [21], [33], [37], [39], [43], [50], [51], [57] Pharmacist [40], [60] Administrator and Managers [36], [53], [57] Patient [4], [17]- [21], [52],…”

To give or not to give: no dearth of explicit guidelines on potentially inappropriate prescribing of non‐steroidal anti‐inflammatory drugs to older adults

“…In particular, the effectiveness of such a strategy will depend on improving usability and the alertuser interface to reduce 'click burden' (more steps required to complete a prescription) and 'alert fatigue' (multiple alerts causing user frustration). 9 Hence, 'to give or not to give' is no longer the question. Instead, future studies should address optimum utilisation of clinical decision support system tools to reduce inappropriate NSAID prescription to older adults and evaluate the clinical impact and economic return on investment of such tools.…”

“…However, it may be challenging to prove that such models of care work effectively as implementation issues may hamper the actual roll out of the models of care. In particular, the effectiveness of such a strategy will depend on improving usability and the alert‐user interface to reduce ‘click burden’ (more steps required to complete a prescription) and ‘alert fatigue’ (multiple alerts causing user frustration) …”

Clinical Decision Support in the Pediatric Hospital Setting

“…If the alerting system provides an excessive amount of alerts of low risk that are frequently overridden, clinicians may become conditioned to habitually ignoring any alert they see. Such "alert fatigue" can then lead a clinician to unintentionally override a potentially serious alert that was lost in the noise of too many nuisance alerts [18][19][20][21]. This issue of alert fatigue in the EHR, as well as excessive alarming of medical devices and monitors throughout the hospital, has held the top spot of the ECRI Institute's Top 10 Health Technology Hazards for the last 3 years [13].…”