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Temporal Change in Alert Override Rate with a Minimally Interruptive Clinical Decision Support on a Next-Generation Electronic Medical Record
oleh: Won Chul Cha, Weon Jung, Jaeyong Yu, Junsang Yoo, Jinwook Choi
Format: | Article |
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Diterbitkan: | MDPI AG 2020-11-01 |
Deskripsi
<i>Background and objectives</i>: The aim of this study is to describe the temporal change in alert override with a minimally interruptive clinical decision support (CDS) on a Next-Generation electronic medical record (EMR) and analyze factors associated with the change. <i>Materials and Methods</i>: The minimally interruptive CDS used in this study was implemented in the hospital in 2016, which was a part of the new next-generation EMR, Data Analytics and Research Window for Integrated kNowledge (DARWIN), which does not generate modals, ‘pop-ups’ but show messages as in-line information. The prescription (medication order) and alerts data from July 2016 to December 2017 were extracted. Piece-wise regression analysis and linear regression analysis was performed to determine the temporal change and factors associated with it. <i>Results</i>: Overall, 2,706,395 alerts and 993 doctors were included in the study. Among doctors, 37.2% were faculty (professors), 17.2% were fellows, and 45.6% trainees (interns and residents). The overall override rate was 61.9%. There was a significant change in an increasing trend at month 12 (<i>p</i> < 0.001). We found doctors’ positions and specialties, along with the number of alerts and medication variability, were significantly associated with the change. <i>Conclusions</i>: In this study, we found a significant temporal change of alert override. We also found factors associated with the change, which had statistical significance.