Evaluation of a user guidance reminder to improve the quality of electronic prescription messages.

Abstract:

BACKGROUND:Prescribers' inappropriate use of the free-text Notes field in new electronic prescriptions can create confusion and workflow disruptions at receiving pharmacies that often necessitates contact with prescribers for clarification. The inclusion of inappropriate patient direction (Sig) information in the Notes field is particularly problematic. OBJECTIVE:We evaluated the effect of a targeted watermark, an embedded overlay, reminder statement in the Notes field of an EHR-based e-prescribing application on the incidence of inappropriate patient directions (Sig) in the Notes field. METHODS:E-prescriptions issued by the same exact cohort of 97 prescribers were collected over three time periods: baseline, three months after implementation of the reminder, and 15 months post implementation. Three certified and experienced pharmacy technicians independently reviewed all e-prescriptions for inappropriate Sig-related information in the Notes field. A physician reviewer served as the final adjudicator for e-prescriptions where the three reviewers could not reach a consensus. ANOVA and post hoc Tukey HSD tests were performed on group comparisons where statistical significance was evaluated at p<0.05. RESULTS:The incidence of inappropriate Sig-related information in the Notes field decreased from a baseline of 2.8% to 1.8% three months post-implementation and remained stable after 15 months. In addition, prescribers' use of the Notes decreased by 22% after 3 months and had stabilized at 18.7% below baseline after 15 months. CONCLUSION:Insertion of a targeted watermark reminder statement in the Notes field of an e-prescribing application significantly reduced the incidence of inappropriate Sig-related information in Notes and decreased prescribers' use of this field.

journal_name

Appl Clin Inform

authors

Dhavle AA,Corley ST,Rupp MT,Ruiz J,Smith J,Gill R,Sow M

doi

10.4338/ACI-2014-03-CR-0022

subject

Has Abstract

pub_date

2014-08-06 00:00:00

pages

699-707

issue

3

issn

1869-0327

journal_volume

5

pub_type

杂志文章
  • Near Field Communication-based telemonitoring with integrated ECG recordings.

    abstract:OBJECTIVES:Telemonitoring of vital signs is an established option in treatment of patients with chronic heart failure (CHF). In order to allow for early detection of atrial fibrillation (AF) which is highly prevalent in the CHF population telemonitoring programs should include electrocardiogram (ECG) signals. It was th...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.4338/ACI-2010-12-RA-0078

    authors: Morak J,Kumpusch H,Hayn D,Leitner M,Scherr D,Fruhwald FM,Schreier G

    更新日期:2011-11-23 00:00:00

  • Clinician Perceptions of a Computerized Decision Support System for Pediatric Type 2 Diabetes Screening.

    abstract:OBJECTIVE:With the increasing prevalence of type 2 diabetes (T2D) in youth, primary care providers must identify patients at high risk and implement evidence-based screening promptly. Clinical decision support systems (CDSSs) provide clinicians with personalized reminders according to best evidence. One example is the ...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.1055/s-0040-1710024

    authors: El Mikati HK,Yazel-Smith L,Grout RW,Downs SM,Carroll AE,Hannon TS

    更新日期:2020-03-01 00:00:00

  • Clinician preferences for verbal communication compared to EHR documentation in the ICU.

    abstract:BACKGROUND:Effective communication is essential to safe and efficient patient care. Additionally, many health information technology (HIT) developments, innovations, and standards aim to implement processes to improve data quality and integrity of electronic health records (EHR) for the purpose of clinical information ...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.4338/ACI-2011-02-RA-0011

    authors: Collins SA,Bakken S,Vawdrey DK,Coiera E,Currie L

    更新日期:2011-06-08 00:00:00

  • Towards meaningful medication-related clinical decision support: recommendations for an initial implementation.

    abstract:SUMMARY:Clinical decision support (CDS) can improve safety, quality, and cost-effectiveness of patient care, especially when implemented in computerized provider order entry (CPOE) applications. Medication-related decision support logic forms a large component of the CDS logic in any CPOE system. However, organizations...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.4338/ACI-2010-04-RA-0026

    authors: Phansalkar S,Wright A,Kuperman GJ,Vaida AJ,Bobb AM,Jenders RA,Payne TH,Halamka J,Bloomrosen M,Bates DW

    更新日期:2011-02-09 00:00:00

  • Common Laboratory Results Frequently Misunderstood by a Sample of Mechanical Turk Users.

    abstract:OBJECTIVES:More patients are receiving their test results via patient portals. Given test results are written using medical jargon, there has been concern that patients may misinterpret these results. Using sample colonoscopy and Pap smear results, our objective was to assess how frequently people can identify the corr...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.1055/s-0039-1679960

    authors: Qureshi N,Mehrotra A,Rudin RS,Fischer SH

    更新日期:2019-03-01 00:00:00

  • The Effectiveness of Hands-on Health Informatics Skills Exercises in the Multidisciplinary Smart Home Healthcare and Health Informatics Training Laboratories.

    abstract:OBJECTIVE:This article aimed to evaluate the effectiveness of newly established innovative smart home healthcare and health informatics laboratories, and a novel laboratory course that focuses on experiential health informatics training, and determine students' self-confidence to operate wireless home health monitoring...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.4338/ACI-2017-08-RA-0136

    authors: Sapci AH,Sapci HA

    更新日期:2017-10-01 00:00:00

  • A Brief Survey on Six Basic and Reduced eHealth Indicators in Seven Countries in 2017.

    abstract:BACKGROUND:Holistic, ubiquitous support of patient-centered health care (eHealth) at all health care institutions and in patients' homes through information processing is increasingly supplementing institution-centered care. While eHealth indicators may measure the transition from institution-centered (e.g., hospital-c...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.1055/s-0038-1669458

    authors: Haux R,Ammenwerth E,Koch S,Lehmann CU,Park HA,Saranto K,Wong CP

    更新日期:2018-07-01 00:00:00

  • A Statewide Medication Management System: Health Information Exchange to Support Drug Therapy Optimization by Pharmacists across the Continuum of Care.

    abstract:BACKGROUND:While evidence generally supports the use of medication management technology, systems are typically implemented and evaluated piecemeal rather than as part of a comprehensive model for medication management. Systems to support drug therapy optimization, increasingly a key role of pharmacists in our healthca...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.1055/s-0037-1620262

    authors: Pellegrin K,Chan F,Pagoria N,Jolson-Oakes S,Uyeno R,Levin A

    更新日期:2018-01-01 00:00:00

  • A qualitative analysis evaluating the purposes and practices of clinical documentation.

    abstract:OBJECTIVES:An important challenge for biomedical informatics researchers is determining the best approach for healthcare providers to use when generating clinical notes in settings where electronic health record (EHR) systems are used. The goal of this qualitative study was to explore healthcare providers' and administ...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.4338/ACI-2013-10-RA-0081

    authors: Ho YX,Gadd CS,Kohorst KL,Rosenbloom ST

    更新日期:2014-02-26 00:00:00

  • Measuring Practicing Clinicians' Information Literacy. An Exploratory Analysis in the Context of Panel Management.

    abstract:BACKGROUND:As healthcare moves towards technology-driven population health management, clinicians must adopt complex digital platforms to access health information and document care. OBJECTIVES:This study explored information literacy, a set of skills required to effectively navigate population health information syst...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.4338/ACI-2016-06-RA-0083

    authors: Dixon BE,Barboza K,Jensen AE,Bennett KJ,Sherman SE,Schwartz MD

    更新日期:2017-02-15 00:00:00

  • The prevalence of obesity documentation in Primary Care Electronic Medical Records. Are we acknowledging the problem?

    abstract:BACKGROUND:Although obesity is a growing problem, primary care physicians often inadequately address it. The objective of this study is to examine the prevalence of obesity documentation in the patient's problem list for patients with eligible body mass indexes (BMI) as contained in the patients' electronic medical rec...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.4338/ACI-2016-07-RA-0115

    authors: Mattar A,Carlston D,Sariol G,Yu T,Almustafa A,Melton GB,Ahmed A

    更新日期:2017-01-25 00:00:00

  • Usability Testing of a Sensor-Controlled Digital Game to Engage Older Adults with Heart Failure in Physical Activity and Weight Monitoring.

    abstract:BACKGROUND: Poor self-management of heart failure (HF) has contributed to poor health outcomes. Sensor-controlled digital games (SCDGs) integrates data from behavior-tracking sensors to trigger progress, rewards, content, and positive feedback in a digital game to motivate real-time behaviors. OBJECTIVES: To assess th...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.1055/s-0040-1721399

    authors: Radhakrishnan K,Julien C,O'Hair M,Baranowski T,Lee G,Allen C,Sagna A,Thomaz E,Kim M

    更新日期:2020-10-01 00:00:00

  • Early Detection of Prediabetes and T2DM Using Wearable Sensors and Internet-of-Things-Based Monitoring Applications.

    abstract:BACKGROUND: Prediabetes and type 2 diabetes mellitus (T2DM) are one of the major long-term health conditions affecting global healthcare delivery. One of the few effective approaches is to actively manage diabetes via a healthy and active lifestyle. OBJECTIVES: This research is focused on early detection of prediabete...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.1055/s-0040-1719043

    authors: Baig MM,GholamHosseini H,Gutierrez J,Ullah E,Lindén M

    更新日期:2021-01-01 00:00:00

  • The contribution of the vaccine adverse event text mining system to the classification of possible Guillain-Barré syndrome reports.

    abstract:BACKGROUND:We previously demonstrated that a general purpose text mining system, the Vaccine adverse event Text Mining (VaeTM) system, could be used to automatically classify reports of an-aphylaxis for post-marketing safety surveillance of vaccines. OBJECTIVE:To evaluate the ability of VaeTM to classify reports to th...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.4338/ACI-2012-11-RA-0049

    authors: Botsis T,Woo EJ,Ball R

    更新日期:2013-02-27 00:00:00

  • Responding to COVID-19: The UW Medicine Information Technology Services Experience.

    abstract:BACKGROUND:UW Medicine was one of the first health systems to encounter and treat COVID-19 patients in the United States, starting in late February 2020. OBJECTIVE:Here we describe the rapid rollout of capabilities by UW Medicine Information Technology Services (ITS) to support our clinical response to the COVID-19 pa...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.1055/s-0040-1709715

    authors: Grange ES,Neil EJ,Stoffel M,Singh AP,Tseng E,Resco-Summers K,Fellner BJ,Lynch JB,Mathias PC,Mauritz-Miller K,Sutton PR,Leu MG

    更新日期:2020-03-01 00:00:00

  • Natural Language Processing for Cohort Discovery in a Discharge Prediction Model for the Neonatal ICU.

    abstract:OBJECTIVES:Discharging patients from the Neonatal Intensive Care Unit (NICU) can be delayed for non-medical reasons including the procurement of home medical equipment, parental education, and the need for children's services. We previously created a model to identify patients that will be medically ready for discharge...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.4338/ACI-2015-09-RA-0114

    authors: Temple MW,Lehmann CU,Fabbri D

    更新日期:2016-02-24 00:00:00

  • Use, Perceived Usability, and Barriers to Implementation of a Patient Safety Dashboard Integrated within a Vendor EHR.

    abstract:BACKGROUND:Preventable adverse events continue to be a threat to hospitalized patients. Clinical decision support in the form of dashboards may improve compliance with evidence-based safety practices. However, limited research describes providers' experiences with dashboards integrated into vendor electronic health rec...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.1055/s-0039-3402756

    authors: Bersani K,Fuller TE,Garabedian P,Espares J,Mlaver E,Businger A,Chang F,Boxer RB,Schnock KO,Rozenblum R,Dykes PC,Dalal AK,Benneyan JC,Lehmann LS,Gershanik EF,Bates DW,Schnipper JL

    更新日期:2020-01-01 00:00:00

  • Ethical Considerations on Pediatric Genetic Testing Results in Electronic Health Records.

    abstract:BACKGROUND:Advances in technology and access to expanded genetic testing have resulted in more children and adolescents receiving genetic testing for diagnostic and prognostic purposes. With increased adoption of the electronic health record (EHR), genetic testing is increasingly resulted in the EHR. However, this lead...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.1055/s-0040-1718753

    authors: Kanungo S,Barr J,Crutchfield P,Fealko C,Soares N

    更新日期:2020-10-01 00:00:00

  • Paradigm shift or annoying distraction: emerging implications of web 2.0 for clinical practice.

    abstract::Web 2.0 technologies, known as social media, social technologies or Web 2.0, have emerged into the mainstream. As they grow, these new technologies have the opportunity to influence the methods and procedures of many fields. This paper focuses on the clinical implications of the growing Web 2.0 technologies. Five deve...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.4338/ACI-2010-01-CR-0003

    authors: Spallek H,O'Donnell J,Clayton M,Anderson P,Krueger A

    更新日期:2010-04-21 00:00:00

  • Empowering Caseworkers to Better Serve the Most Vulnerable with a Cloud-Based Care Management Solution.

    abstract:BACKGROUND:Care-management tools are typically utilized for chronic disease management. Sonoma County government agencies employed advanced health information technologies, artificial intelligence (AI), and interagency process improvements to help transform health and health care for socially disadvantaged groups and o...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.1055/s-0040-1715894

    authors: Snowdon JL,Robinson B,Staats C,Wolsey K,Sands-Lincoln M,Strasheim T,Brotman D,Keating K,Schnitter E,Jackson G,Kassler W

    更新日期:2020-08-01 00:00:00

  • The Effects of Medication Alerts on Prescriber Response in a Pediatric Hospital.

    abstract:OBJECTIVE:More than 70% of hospitals in the United States have electronic health records (EHRs). Clinical decision support (CDS) presents clinicians with electronic alerts during the course of patient care; however, alert fatigue can influence a provider's response to any EHR alert. The primary goal was to evaluate the...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.4338/ACI-2016-10-RA-0168

    authors: Dexheimer JW,Kirkendall ES,Kouril M,Hagedorn PA,Minich T,Duan LL,Mahdi M,Szczesniak R,Spooner SA

    更新日期:2017-05-10 00:00:00

  • Impact of homecare electronic health record on timeliness of clinical documentation, reimbursement, and patient outcomes.

    abstract:BACKGROUND:Homecare is an important and effective way of managing chronic illnesses using skilled nursing care in the home. Unlike hospitals and ambulatory settings, clinicians visit patients at home at different times, independent of each other. Twenty-nine percent of 10,000 homecare agencies in the United States have...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.4338/ACI-2013-12-RA-0106

    authors: Sockolow PS,Bowles KH,Adelsberger MC,Chittams JL,Liao C

    更新日期:2014-04-30 00:00:00

  • Evaluation of a Korean version of a tool for assessing the incorporation of human factors into a medication-related decision support system: the I-MeDeSA.

    abstract:OBJECTIVE:The Instrument for Evaluating Human-Factor Principles in Medication-Related Decision Support Alerts (I-MeDeSA) was developed recently in the US with a view towards improving considerations of human-factor principles when designing alerts for clinical decision support (CDS) systems. This study evaluated the ge...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.4338/ACI-2014-01-RA-0005

    authors: Cho I,Lee J,Han H,Phansalkar S,Bates DW

    更新日期:2014-06-18 00:00:00

  • Potential of an Electronic Health Record-Integrated Patient Portal for Improving Care Plan Concordance during Acute Care.

    abstract:BACKGROUND:Care plan concordance among patients and clinicians during hospitalization is suboptimal. OBJECTIVE:This article determines whether an electronic health record (EHR)-integrated patient portal was associated with increased understanding of the care plan, including the key recovery goal, among patients and cl...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.1055/s-0039-1688831

    authors: Dalal AK,Dykes P,Samal L,McNally K,Mlaver E,Yoon CS,Lipsitz SR,Bates DW

    更新日期:2019-05-01 00:00:00

  • Electronic Health Records in Danish Home Care and Nursing Homes: Inadequate Documentation of Care, Medication, and Consent.

    abstract:BACKGROUND: Electronic health records (EHRs) are used in long-term care to document the patients' condition, medication, and care, thereby supporting communication among caregivers and counteracting adverse drug events. However, the use of EHRs in long-term care has lagged behind EHR use in hospitals. In addition, most...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.1055/s-0040-1721013

    authors: Hertzum M

    更新日期:2021-01-01 00:00:00

  • Towards Implementation of OMOP in a German University Hospital Consortium.

    abstract:BACKGROUND:In 2015, the German Federal Ministry of Education and Research initiated a large data integration and data sharing research initiative to improve the reuse of data from patient care and translational research. The Observational Medical Outcomes Partnership (OMOP) common data model and the Observational Healt...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.1055/s-0037-1617452

    authors: Maier C,Lang L,Storf H,Vormstein P,Bieber R,Bernarding J,Herrmann T,Haverkamp C,Horki P,Laufer J,Berger F,Höning G,Fritsch HW,Schüttler J,Ganslandt T,Prokosch HU,Sedlmayr M

    更新日期:2018-01-01 00:00:00

  • Consensus Statement: Feature and Function Recommendations to Optimize Clinician Usability of Direct Interoperability to Enhance Patient Care.

    abstract:BACKGROUND:Secure clinical messaging and document exchange utilizing the Direct Protocol (Direct interoperability) has been widely implemented in health information technology (HIT) applications including electronic health records (EHRs) and by health care providers and organizations in the United States. While Direct ...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.1055/s-0038-1637007

    authors: Lane SR,Miller H,Ames E,Garber L,Kibbe DC,Schneider JH,Lehmann CU,DirectTrust Clinicians' Steering Group.

    更新日期:2018-01-01 00:00:00

  • Registers for Networked Medical Research in Germany: Situation and prospects.

    abstract:BACKGROUND:Several disease specific registers are operated by members of the 'TMF - Technology, Methods, and Infrastructure for Networked Medical Research', an umbrella organization of research networks in Germany. OBJECTIVE:To describe the coverage and the current state as well as financial and organizational issues ...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.4338/ACI-2010-04-RA-0024

    authors: Stausberg J,Altmann U,Antony G,Drepper J,Sax U,Schütt A

    更新日期:2010-11-24 00:00:00

  • Identification of Long Bone Fractures in Radiology Reports Using Natural Language Processing to support Healthcare Quality Improvement.

    abstract:BACKGROUND:Important information to support healthcare quality improvement is often recorded in free text documents such as radiology reports. Natural language processing (NLP) methods may help extract this information, but these methods have rarely been applied outside the research laboratories where they were develop...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章

    doi:10.4338/ACI-2016-08-RA-0129

    authors: Grundmeier RW,Masino AJ,Casper TC,Dean JM,Bell J,Enriquez R,Deakyne S,Chamberlain JM,Alpern ER,Pediatric Emergency Care Applied Research Network.

    更新日期:2016-11-09 00:00:00

  • Legal and regulatory considerations associated with use of patient-generated health data from social media and mobile health (mHealth) devices.

    abstract::Patient-generated health data are coming into broader use across the health care spectrum and hold great promise as a means to improve care and health outcomes. At the same time, rapid evolution in the social media and mobile health (mHealth) market has promoted an environment in which creation and transmission of per...

    journal_title:Applied clinical informatics

    pub_type: 杂志文章,评审

    doi:10.4338/ACI-2014-09-R-0082

    authors: Petersen C,DeMuro P

    更新日期:2015-01-14 00:00:00