The Impact of Prescribing Safety Alerts for Elderly Persons in an Electronic Medical Record

Abstract

We found that alerts in an outpatient electronic medical record aimed at decreasing prescribing of medication use in elderly persons may be an effective method of reducing prescribing of contraindicated medications. The effect of the alerts on patient outcomes is less certain and deserves further investigation.

Thoracic Endometriosis Syndrome: Case Report and Review of the Literature

“…[55][56][57][58][59][60][61][62][63][64][65][66][67][68][69] In addition, there were 12 studies that compared KP with international health care systems. 55,58,62,63,[70][71][72][73][74][75][76][77] Among the different topical areas that the comparative health systems studies covered, the most frequently studied topic was quality of care (n = 30) a and articles that related to health information technology/EHR/clinical decision support/telemedicine (n = 18). b Other commonly studied topics included resource use (cost/utilization; n = 16), c health systems performance (n = 7), 14,59,61,70,72,73,76 and disease management (n = 7).…”

Comparative Health Systems Research among Kaiser Permanente and Other Integrated Delivery Systems: A Systematic Literature Review

“…Fewer studies (n = 15) were identified that compared KP with another US health care system (ie, fee-for-service, health maintenance organization, and/or Veterans Affairs). [55][56][57][58][59][60][61][62][63][64][65][66][67][68][69] In addition, there were 12 studies that compared KP with international health care systems. 55,58,62,63,[70][71][72][73][74][75][76][77] Among the different topical areas that the comparative health systems studies covered, the most frequently studied topic was quality of care (n = 30) a and articles that related to health information technology/EHR/clinical decision support/telemedicine (n = 18).…”

Transitioning Between Electronic Health Records: Effects on Ambulatory Prescribing Safety

“…Multiple studies have shown that providers frequently override alerts because they are perceived as irrelevant [39][40][41][42] . The inability of EHR systems to effectively present information for CDS purposes may contribute to the mixed safety benefits observed in studies 1,[7][8][9][10]12,13 . In our study, for example, the newer system generated two alerts at separate steps in the ordering process to target inappropriate abbreviations.…”

“…By determining drug classes most frequently involved in errors, CDS can be developed specifically to reduce these errors. Targeted alerts for certain prescribing errors have been shown to be effective [8][9][10] . In addition, it can also guide calibration of CDS such that there is a higher sensitivity to trigger alerts.…”

“…Research on the ability of e-prescribing to improve safety has predominantly come from the inpatient setting and on locally developed systems created by organizations for their own use [3][4][5] . Fewer studies have been conducted on commercial systems or in the outpatient setting and results have been mixed [6][7][8][9][10][11][12][13] . To ensure that federal spending is directed toward effective interventions, it is important to evaluate the effect of e-prescribing on safety in the ambulatory setting, where most prescribing occurs and errors are common 7,[12][13][14][15] .…”