title: Medical exceptions to decision support: a tool to identify provider misconceptions and direct academic detailing.
abstract: Clinical decision support can be used to capture the medical exceptions that justify deviations from guideline-based care. Peer review of this data is a potentially valuable and efficient means of identifying physician misconceptions or gaps in the medical knowledge base. Our early experience performing peer review on medical exceptions recorded through computerized point-of-care alerts shows that most medical exceptions were legitimate. Twelve percent of exceptions were inappropriate and 10% involved areas of considerable medical uncertainty.
authors.affiliation: Division of General Internal Medicine, Feinberg School of Medicine, USA.
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Persell
authors.forename: Nancy C
authors.initials: NC
authors.lastname: Dolan
authors.forename: David W
authors.initials: DW
authors.lastname: Baker
mesh_terms: D001291:Attitude of Health Personnel; D003657:Decision Making; D020000:Decision Support Systems, Clinical / Q000706:statistics & numerical data*; D019300:Medical Errors / Q000517:prevention & control* / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D014481:United States