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Understanding responses to a renal dosing decision support system in primary care

Cho, I.; Slight, S.P.; Nanji, K.C.; Seger, D.L.; Dykes, P.C.; Bates, D.W.

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Authors

I. Cho

S.P. Slight

K.C. Nanji

D.L. Seger

P.C. Dykes

D.W. Bates



Contributors

Christoph Ulrich Lehmann
Editor

Elske Ammenwerth
Editor

Christian Nøhr
Editor

Abstract

Renal dosing clinical decision support (CDS) systems have demonstrated clinical effectiveness and potential benefits for patient outcomes. However, the high override rates consistently reported are problematic and undesirable. To understand providers' use patterns of renal dosing CDS, we investigated the override reasons obtained from primary care practices affiliated with two teaching hospitals. We selected a stratified random sample of 300 alerts and reviewed electronic medical records. Appropriateness criteria and an inter-rater reliability process were used. We found that two thirds of alerts were overridden inappropriately, and this proportion was similar for frequent over-riders as compared to the remainder of physicians. These findings imply that strategies are needed to convince providers to accept more clinically appropriate suggestions, though they need to be broadly targeted.

Citation

Cho, I., Slight, S., Nanji, K., Seger, D., Dykes, P., & Bates, D. (2013). Understanding responses to a renal dosing decision support system in primary care. In C. U. Lehmann, E. Ammenwerth, & C. Nøhr (Eds.), Medinfo 2013 : proceedings of the 14th world congress on medical and health informatics (931-931). IOS Press. https://doi.org/10.3233/978-1-61499-289-9-931

Online Publication Date Aug 1, 2013
Publication Date Aug 1, 2013
Deposit Date Oct 30, 2013
Publicly Available Date Aug 8, 2014
Publisher IOS Press
Pages 931-931
Series Title Studies in health technology and informatics.
Book Title Medinfo 2013 : proceedings of the 14th world congress on medical and health informatics.
ISBN 9781614992882
DOI https://doi.org/10.3233/978-1-61499-289-9-931
Keywords Clinical decision support systems, Electronic prescribing, Renal dosing, Primary health care.
Additional Information This book presents the proceedings of the MEDINFO 2013 conference, held in Copenhagen, Denmark, in August 2013. The theme of the conference is "Conducting medical informatics by converging technologies, conveying sciences and connecting people".

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Publisher Licence URL
http://creativecommons.org/licenses/by-nc/4.0/

Copyright Statement
© 2013 IMIA and IOS Press.
This article is published online with Open Access by IOS Press and distributed under the terms
of the Creative Commons Attribution Non-Commercial License.




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