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Journal of the American Medical Informatics Association | 2006

Improving Acceptance of Computerized Prescribing Alerts in Ambulatory Care

Nidhi R. Shah; Andrew C. Seger; Diane L. Seger; Julie M. Fiskio; Gilad J. Kuperman; Barry H. Blumenfeld; Elaine G. Recklet; David W. Bates; Tejal K. Gandhi

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.


eGEMs (Generating Evidence & Methods to improve patient outcomes) | 2018

The imperative for patient-centered clinical decision support:

Laura H. Marcial; Joshua E. Richardson; Beth M. Lasater; Blackford Middleton; Jerome A. Osheroff; Kensaku Kawamoto; Jessica S. Ancker; Danny van Leeuwen; Edwin A. Lomotan; Shafa Al-Showk; Barry H. Blumenfeld

This commentary introduces the Patient-Centered Clinical Decision Support (PCCDS) Learning Network, which is collaborating with AcademyHealth to publish “Better Decisions Together” as part of eGEMs. Patient-centered clinical decision support (CDS) is an important vehicle to address broad issues in the U.S. health care system regarding quality and safety while also achieving better outcomes and better patient and provider satisfaction. Defined as CDS that supports individual patients and their care givers and/or care teams in health-related decisions and actions, PCCDS is an important step forward in advancing endeavors to move patient-centered care forward. The PCCDS Learning Network has developed a framework, referred to as the Analytic Framework for Action (AFA), to organize thinking and activities around PCCDS. A wide array of activities the PCCDS Learning Network is engaging in to inform and connect stakeholders is discussed.


Annals of Internal Medicine | 1991

Physicians' Information Needs: Analysis of Questions Posed during Clinical Teaching

Jerome A. Osheroff; Diana E. Forsythe; Bruce G. Buchanan; Richard A. Bankowitz; Barry H. Blumenfeld; Randolph A. Miller


Journal of the American Medical Informatics Association | 2006

Design and Implementation of an Application and Associated Services to Support Interdisciplinary Medication Reconciliation Efforts at an Integrated Healthcare Delivery Network

Eric G. Poon; Barry H. Blumenfeld; Claus Hamann; Alexander Turchin; Erin Graydon-Baker; Patricia McCarthy; John Poikonen; Perry Mar; Jeffrey L. Schnipper; Robert K. Hallisey; Sandra Smith; Christine McCormack; Marilyn D. Paterno; Christopher M. Coley; Andrew S. Karson; Henry C. Chueh; Cheryl Van Putten; Sally Millar; Margaret D. Clapp; Ishir Bhan; Gregg S. Meyer; Tejal K. Gandhi; Carol A. Broverman


american medical informatics association annual symposium | 2003

Creating an enterprise-wide allergy repository at Partners HealthCare System.

Gilad J. Kuperman; Edna Marston; Marilyn D. Paterno; Jennifer Rogala; Nina Plaks; Carol Hanson; Barry H. Blumenfeld; Blackford Middleton; Cindy Spurr; Rainu Kaushal; Tejal K. Gandhi; David W. Bates


american medical informatics association annual symposium | 2005

Improving Override Rates for Computerized Prescribing Alerts in Ambulatory Care

Nidhi R. Shah; Andrew C. Seger; Diane L. Seger; Julie M. Fiskio; Gilad J. Kuperman; Barry H. Blumenfeld; Elaine G. Recklet; David W. Bates; Tejal K. Gandhi


american medical informatics association annual symposium | 2005

Designing an electronic medication reconciliation system.

Claus Hamann; Eric G. Poon; Sandra Smith; Christopher M. Coley; Erin Graydon-Baker; Tejal K. Gandhi; Henry C. Chueh; John Poikonen; Robert K. Hallisey; Cheryl Van Putten; Carol A. Broverman; Barry H. Blumenfeld; Blackford Middleton


american medical informatics association annual symposium | 2003

Enterprise-wide Drug-Drug Interaction Alerting System

Julie A. Greim; Caroline Shek; Linda Jones; Robert Macauley; Marilyn D. Paterno; Barry H. Blumenfeld; Gilad J. Kuperman


american medical informatics association annual symposium | 2002

End of visit: design considerations for an ambulatory order entry module.

Samuel J. Wang; Barry H. Blumenfeld; Susan E. Roche; Julia A. Greim; Karen E. Burk; Tejal K. Gandhi; David W. Bates; Gilad J. Kuperman


american medical informatics association annual symposium | 2002

The Potential Economic Impact of Ambulatory Physician Order Entry at a Large Integrated Delivery Network

Barry H. Blumenfeld; Samuel J. Wang; Julie A. Greim; Gilad J. Kuperman

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David W. Bates

Brigham and Women's Hospital

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Andrew C. Seger

Brigham and Women's Hospital

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