title: Attitude of physicians towards automatic alerting in computerized physician order entry systems. A comparative international survey.
abstract: OBJECTIVE
  To analyze the attitude of physicians towards alerting in CPOE systems in different hospitals in different countries, addressing various organizational and technical settings and the view of physicians not currently using a CPOE.
  
  
  METHODS
  A cross-sectional quantitative and qualitative questionnaire survey. We invited 2,600 physicians in eleven hospitals from nine countries to participate. Eight of the hospitals had different CPOE systems in use, and three of the participating hospitals were not using a CPOE system.
  
  
  RESULTS
  1,018 physicians participated. The general attitude of the physicians towards CPOE alerting is positive and is found to be mostly independent of the country, the specific organizational settings in the hospitals and their personal experience with CPOE systems. Both quantitative and qualitative results show that the majority of the physicians, both CPOE-users and non-users, appreciate the benefits of alerting in CPOE systems on medication safety. However, alerting should be better adapted to the clinical context and make use of more sophisticated ways to present alert information. The vast majority of physicians agree that additional information regarding interactions is useful on demand. Around half of the respondents see possible alert overload as a major problem; in this regard, physicians in hospitals with sophisticated alerting strategies show partly better attitude scores.
  
  
  CONCLUSIONS
  Our results indicate that the way alerting information is presented to the physicians may play a role in their general attitude towards alerting, and that hospitals with a sophisticated alerting strategy with less interruptive alerts tend towards more positive attitudes. This aspect needs to be further investigated in future studies.
authors.affiliation: Institute of Health Informatics, Department of Biomedical Informatics and Mechatronics, UMIT-University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Jung
authors.forename: A
authors.initials: A
authors.lastname: Hoerbst
authors.forename: W O
authors.initials: WO
authors.lastname: Hackl
authors.forename: F
authors.initials: F
authors.lastname: Kirrane
authors.forename: D
authors.initials: D
authors.lastname: Borbolla
authors.forename: M W
authors.initials: MW
authors.lastname: Jaspers
authors.forename: M
authors.initials: M
authors.lastname: Oertle
authors.forename: V
authors.initials: V
authors.lastname: Koutkias
authors.forename: L
authors.initials: L
authors.lastname: Ferret
authors.forename: P
authors.initials: P
authors.lastname: Massari
authors.forename: K
authors.initials: K
authors.lastname: Lawton
authors.forename: D
authors.initials: D
authors.lastname: Riedmann
authors.forename: S
authors.initials: S
authors.lastname: Darmoni
authors.forename: N
authors.initials: N
authors.lastname: Maglaveras
authors.forename: C
authors.initials: C
authors.lastname: Lovis
authors.forename: E
authors.initials: E
authors.lastname: Ammenwerth
mesh_terms: D001291:Attitude of Health Personnel; D056902:Clinical Alarms; D019538:Health Care Surveys; D006801:Humans; D038622:Internationality; D050316:Medical Order Entry Systems; D008505:Medical Staff, Hospital / Q000523:psychology*; D036301:Qualitative Research