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DOI: 10.1055/s-0039-1697596
Differences, Opportunities, and Strategies in Drug Alert Optimization—Experiences of Two Different Integrated Health Care Systems
Funding None.Publikationsverlauf
21. März 2019
05. August 2019
Publikationsdatum:
16. Oktober 2019 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00035026/201905/lookinside/thumbnails/10-1055-s-0039-1697596_190058cr-1.jpg)
Abstract
Background Concerns about the number of automated medication alerts issued within the electronic health record (EHR), and the subsequent potential for alarm fatigue, led us to examine strategies and methods to optimize the configuration of our drug alerts.
Objectives This article reports on comprehensive drug alerting rates and develops strategies across two different health care systems to reduce the number of drug alerts.
Methods Standardized reports compared drug alert rates between the two systems, among 13 categories of drug alerts. Both health care systems made modifications to the out-of-box alerts available from their EHR and drug information vendors, focusing on system-wide approaches, when relevant, while performing more drug-specific changes when necessary.
Results Drug alerting rates even after initial optimization were 38 alerts and 51 alerts per 100 drug orders, respectively. Eight principles were identified and developed to reflect the themes in the implementation and optimization of drug alerting.
Conclusion A team-based, systematic approach to optimizing drug-alerting strategies can reduce the number of drug alerts, but alert rates still remain high. In addition to strategic principles, additional tactical guidelines and recommendations need to be developed to enhance out-of-the-box clinical decision support for drug alerts.
Keywords
clinical decision support - process management tools - specific types - clinical information systems - drug–drug interaction - alerting - system improvement - alert fatigueAuthors' Contributions
All authors made substantial contributions to the manuscript. S.S. and K.D. served as the lead authors, conducting data analysis and leading manuscript preparation and writing. D.K. provided substantial guidance, feedback, and edits during the research and edit process. All authors have approved this work.
Protection of Human and Animal subjects
No human subjects were involved in the project.
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