Clinical alerts may help reduce dangerous drug interactions, but sometimes they cause more problems than they solve. Experts describe best practices to make them work better.
Clinicians, whether young or old, technophobes or technophiles, continue to complain about the avalanche of unnecessary alerts they get when walking through a clinical decision support or e-prescribing system. It's not uncommon to hear a cardiologist, for instance, complain: "I've been practicing for 15 years. I don't need to be cautioned about ordering aspirin for a patient at risk of hemorrhagic stroke."
On the flip side, IT leaders and clinicians worry that these systems miss needed alerts because they're incapable of taking into account important free text data from clinicians' notes. Allison McCoy and her colleagues at the Department of Biomedical Informatics, Vanderbilt University School of Medicine, give a good example in a recent Journal of the American Medical Informatics Association (JAMIA) report.. They give the example of an infectious disease specialist who orders a powerful antibiotic for a life-threatening infection in a patient with compromised kidney function, and who inserts that fact into the clinician's notes.