title: Development of a context model to prioritize drug safety alerts in CPOE systems.
abstract: BACKGROUND
  Computerized physician order entry systems (CPOE) can reduce the number of medication errors and adverse drug events (ADEs) in healthcare institutions. Unfortunately, they tend to produce a large number of partly irrelevant alerts, in turn leading to alert overload and causing alert fatigue. The objective of this work is to identify factors that can be used to prioritize and present alerts depending on the 'context' of a clinical situation.
  
  
  METHODS
  We used a combination of literature searches and expert interviews to identify and validate the possible context factors. The internal validation of the context factors was performed by calculating the inter-rater agreement of two researcher's classification of 33 relevant articles.
  
  
  RESULTS
  We developed a context model containing 20 factors. We grouped these context factors into three categories: characteristics of the patient or case (e.g. clinical status of the patient); characteristics of the organizational unit or user (e.g. professional experience of the user); and alert characteristics (e.g. severity of the effect). The internal validation resulted in nearly perfect agreement (Cohen's Kappa value of 0.97).
  
  
  CONCLUSIONS
  To our knowledge, this is the first structured attempt to develop a comprehensive context model for prioritizing drug safety alerts in CPOE systems. The outcome of this work can be used to develop future tailored drug safety alerting in CPOE systems.
authors: Institute of Health Informatics, UMIT-University for Health Sciences, Medical Informatics and Technology, Eduard Wallnöfer-Zentrum I, Hall in Tirol, Austria.
authors: Daniel
authors: D
authors: Riedmann
authors: Martin
authors: M
authors: Jung
authors: Werner O
authors: WO
authors: Hackl
authors: Wolf
authors: W
authors: Stühlinger
authors: Heleen
authors: H
authors: van der Sijs
authors: Elske
authors: E
authors: Ammenwerth
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