Overrides of clinical decision support alerts in primary care clinics.
Clinical Decision Support (CDS) systems can alert physicians about potential clinical risks and suggest suitable treatment alternatives at appropriate times in the health care process. We evaluated the frequency with which physicians overrode medication alerts and the override reasons provided. Data obtained from primary care practices affiliated with two Harvard teaching hospitals were downloaded. Physicians overrode more than half of CDS medication alerts, with formulary, age-based, and renal substitutions the most likely. Many drug-drug and drug-allergy interactions overridden had the potential to cause patient harm.
Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Sarah P
SP
Slight
Karen C
KC
Nanji
Diane L
DL
Seger
Insook
I
Cho
Lynn A
LA
Volk
David W
DW
Bates
D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data*; D001900:Boston / Q000453:epidemiology; D020000:Decision Support Systems, Clinical / Q000706:statistics & numerical data*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000145:classification / Q000453:epidemiology* / Q000517:prevention & control*; D055695:Electronic Prescribing / Q000706:statistics & numerical data*; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control* / Q000706:statistics & numerical data*; D061214:Patient Safety / Q000706:statistics & numerical data; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data