Recommendations to improve the usability of drug-drug interaction clinical decision support alerts

Thomas H. Payne, Lisa E. Hines, Raymond C. Chan, Seth Hartman, Joan Kapusnik-Uner, Alissa L. Russ, Bruce W. Chaffee, Christian Hartman, Victoria Tamis, Brian Galbreth, Peter A. Glassman, Shobha Phansalkar, Heleen van der Sijs, Sheila M Gephart, Gordon Mann, Howard R. Strasberg, Amy J Jones-Grizzle, Mary Brown, Gilad J. Kuperman, Chris SteinerAmanda Sullins, Hugh Ryan, Michael A. Wittie, Daniel C Malone

Research output: Contribution to journalArticle

77 Citations (Scopus)

Abstract

Objective: To establish preferred strategies for presenting drug-drug interaction (DDI) clinical decision support alerts. Materials and Methods: A DDI Clinical Decision Support Conference Series included a workgroup consisting of 24 clinical, usability, and informatics experts representing academia, health information technology (IT) vendors, healthcare organizations, and the Office of the National Coordinator for Health IT. Workgroup members met via web-based meetings 12 times from January 2013 to February 2014, and two in-person meetings to reach consensus on recommendations to improve decision support for DDIs. We addressed three key questions: (1) what, how, where, and when do we display DDI decision support? (2) should presentation of DDI decision support vary by clinicians? and (3) how should effectiveness of DDI decision support be measured? Results: Our recommendations include the consistent use of terminology, visual cues, minimal text, formatting, content, and reporting standards to facilitate usability. All clinicians involved in the medication use process should be able to view DDI alerts and actions by other clinicians. Override rates are common but may not be a good measure of effectiveness. Discussion: Seven core elements should be included with DDI decision support. DDI information should be presented to all clinicians. Finally, in their current form, override rates have limited capability to evaluate alert effectiveness. Conclusion: DDI clinical decision support alerts need major improvements. We provide recommendations for healthcare organizations and IT vendors to improve the clinician interface of DDI alerts, with the aim of reducing alert fatigue and improving patient safety.

Original languageEnglish (US)
Pages (from-to)1243-1250
Number of pages8
JournalJournal of the American Medical Informatics Association
Volume22
Issue number6
DOIs
StatePublished - 2015

Fingerprint

Clinical Decision Support Systems
Drug Interactions
Pharmaceutical Preparations
Medical Informatics
Delivery of Health Care
Patient Safety
Terminology
Fatigue
Cues
Consensus

Keywords

  • Alerts
  • Clinical decision support
  • CPOE (up to 5)
  • Drug interactions
  • Usability

ASJC Scopus subject areas

  • Health Informatics

Cite this

Recommendations to improve the usability of drug-drug interaction clinical decision support alerts. / Payne, Thomas H.; Hines, Lisa E.; Chan, Raymond C.; Hartman, Seth; Kapusnik-Uner, Joan; Russ, Alissa L.; Chaffee, Bruce W.; Hartman, Christian; Tamis, Victoria; Galbreth, Brian; Glassman, Peter A.; Phansalkar, Shobha; van der Sijs, Heleen; Gephart, Sheila M; Mann, Gordon; Strasberg, Howard R.; Jones-Grizzle, Amy J; Brown, Mary; Kuperman, Gilad J.; Steiner, Chris; Sullins, Amanda; Ryan, Hugh; Wittie, Michael A.; Malone, Daniel C.

In: Journal of the American Medical Informatics Association, Vol. 22, No. 6, 2015, p. 1243-1250.

Research output: Contribution to journalArticle

Payne, TH, Hines, LE, Chan, RC, Hartman, S, Kapusnik-Uner, J, Russ, AL, Chaffee, BW, Hartman, C, Tamis, V, Galbreth, B, Glassman, PA, Phansalkar, S, van der Sijs, H, Gephart, SM, Mann, G, Strasberg, HR, Jones-Grizzle, AJ, Brown, M, Kuperman, GJ, Steiner, C, Sullins, A, Ryan, H, Wittie, MA & Malone, DC 2015, 'Recommendations to improve the usability of drug-drug interaction clinical decision support alerts', Journal of the American Medical Informatics Association, vol. 22, no. 6, pp. 1243-1250. https://doi.org/10.1093/jamia/ocv011
Payne, Thomas H. ; Hines, Lisa E. ; Chan, Raymond C. ; Hartman, Seth ; Kapusnik-Uner, Joan ; Russ, Alissa L. ; Chaffee, Bruce W. ; Hartman, Christian ; Tamis, Victoria ; Galbreth, Brian ; Glassman, Peter A. ; Phansalkar, Shobha ; van der Sijs, Heleen ; Gephart, Sheila M ; Mann, Gordon ; Strasberg, Howard R. ; Jones-Grizzle, Amy J ; Brown, Mary ; Kuperman, Gilad J. ; Steiner, Chris ; Sullins, Amanda ; Ryan, Hugh ; Wittie, Michael A. ; Malone, Daniel C. / Recommendations to improve the usability of drug-drug interaction clinical decision support alerts. In: Journal of the American Medical Informatics Association. 2015 ; Vol. 22, No. 6. pp. 1243-1250.
@article{a329439ce8994ce3a6ce44eeefa64e41,
title = "Recommendations to improve the usability of drug-drug interaction clinical decision support alerts",
abstract = "Objective: To establish preferred strategies for presenting drug-drug interaction (DDI) clinical decision support alerts. Materials and Methods: A DDI Clinical Decision Support Conference Series included a workgroup consisting of 24 clinical, usability, and informatics experts representing academia, health information technology (IT) vendors, healthcare organizations, and the Office of the National Coordinator for Health IT. Workgroup members met via web-based meetings 12 times from January 2013 to February 2014, and two in-person meetings to reach consensus on recommendations to improve decision support for DDIs. We addressed three key questions: (1) what, how, where, and when do we display DDI decision support? (2) should presentation of DDI decision support vary by clinicians? and (3) how should effectiveness of DDI decision support be measured? Results: Our recommendations include the consistent use of terminology, visual cues, minimal text, formatting, content, and reporting standards to facilitate usability. All clinicians involved in the medication use process should be able to view DDI alerts and actions by other clinicians. Override rates are common but may not be a good measure of effectiveness. Discussion: Seven core elements should be included with DDI decision support. DDI information should be presented to all clinicians. Finally, in their current form, override rates have limited capability to evaluate alert effectiveness. Conclusion: DDI clinical decision support alerts need major improvements. We provide recommendations for healthcare organizations and IT vendors to improve the clinician interface of DDI alerts, with the aim of reducing alert fatigue and improving patient safety.",
keywords = "Alerts, Clinical decision support, CPOE (up to 5), Drug interactions, Usability",
author = "Payne, {Thomas H.} and Hines, {Lisa E.} and Chan, {Raymond C.} and Seth Hartman and Joan Kapusnik-Uner and Russ, {Alissa L.} and Chaffee, {Bruce W.} and Christian Hartman and Victoria Tamis and Brian Galbreth and Glassman, {Peter A.} and Shobha Phansalkar and {van der Sijs}, Heleen and Gephart, {Sheila M} and Gordon Mann and Strasberg, {Howard R.} and Jones-Grizzle, {Amy J} and Mary Brown and Kuperman, {Gilad J.} and Chris Steiner and Amanda Sullins and Hugh Ryan and Wittie, {Michael A.} and Malone, {Daniel C}",
year = "2015",
doi = "10.1093/jamia/ocv011",
language = "English (US)",
volume = "22",
pages = "1243--1250",
journal = "Journal of the American Medical Informatics Association : JAMIA",
issn = "1067-5027",
publisher = "Oxford University Press",
number = "6",

}

TY - JOUR

T1 - Recommendations to improve the usability of drug-drug interaction clinical decision support alerts

AU - Payne, Thomas H.

AU - Hines, Lisa E.

AU - Chan, Raymond C.

AU - Hartman, Seth

AU - Kapusnik-Uner, Joan

AU - Russ, Alissa L.

AU - Chaffee, Bruce W.

AU - Hartman, Christian

AU - Tamis, Victoria

AU - Galbreth, Brian

AU - Glassman, Peter A.

AU - Phansalkar, Shobha

AU - van der Sijs, Heleen

AU - Gephart, Sheila M

AU - Mann, Gordon

AU - Strasberg, Howard R.

AU - Jones-Grizzle, Amy J

AU - Brown, Mary

AU - Kuperman, Gilad J.

AU - Steiner, Chris

AU - Sullins, Amanda

AU - Ryan, Hugh

AU - Wittie, Michael A.

AU - Malone, Daniel C

PY - 2015

Y1 - 2015

N2 - Objective: To establish preferred strategies for presenting drug-drug interaction (DDI) clinical decision support alerts. Materials and Methods: A DDI Clinical Decision Support Conference Series included a workgroup consisting of 24 clinical, usability, and informatics experts representing academia, health information technology (IT) vendors, healthcare organizations, and the Office of the National Coordinator for Health IT. Workgroup members met via web-based meetings 12 times from January 2013 to February 2014, and two in-person meetings to reach consensus on recommendations to improve decision support for DDIs. We addressed three key questions: (1) what, how, where, and when do we display DDI decision support? (2) should presentation of DDI decision support vary by clinicians? and (3) how should effectiveness of DDI decision support be measured? Results: Our recommendations include the consistent use of terminology, visual cues, minimal text, formatting, content, and reporting standards to facilitate usability. All clinicians involved in the medication use process should be able to view DDI alerts and actions by other clinicians. Override rates are common but may not be a good measure of effectiveness. Discussion: Seven core elements should be included with DDI decision support. DDI information should be presented to all clinicians. Finally, in their current form, override rates have limited capability to evaluate alert effectiveness. Conclusion: DDI clinical decision support alerts need major improvements. We provide recommendations for healthcare organizations and IT vendors to improve the clinician interface of DDI alerts, with the aim of reducing alert fatigue and improving patient safety.

AB - Objective: To establish preferred strategies for presenting drug-drug interaction (DDI) clinical decision support alerts. Materials and Methods: A DDI Clinical Decision Support Conference Series included a workgroup consisting of 24 clinical, usability, and informatics experts representing academia, health information technology (IT) vendors, healthcare organizations, and the Office of the National Coordinator for Health IT. Workgroup members met via web-based meetings 12 times from January 2013 to February 2014, and two in-person meetings to reach consensus on recommendations to improve decision support for DDIs. We addressed three key questions: (1) what, how, where, and when do we display DDI decision support? (2) should presentation of DDI decision support vary by clinicians? and (3) how should effectiveness of DDI decision support be measured? Results: Our recommendations include the consistent use of terminology, visual cues, minimal text, formatting, content, and reporting standards to facilitate usability. All clinicians involved in the medication use process should be able to view DDI alerts and actions by other clinicians. Override rates are common but may not be a good measure of effectiveness. Discussion: Seven core elements should be included with DDI decision support. DDI information should be presented to all clinicians. Finally, in their current form, override rates have limited capability to evaluate alert effectiveness. Conclusion: DDI clinical decision support alerts need major improvements. We provide recommendations for healthcare organizations and IT vendors to improve the clinician interface of DDI alerts, with the aim of reducing alert fatigue and improving patient safety.

KW - Alerts

KW - Clinical decision support

KW - CPOE (up to 5)

KW - Drug interactions

KW - Usability

UR - http://www.scopus.com/inward/record.url?scp=84945490735&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84945490735&partnerID=8YFLogxK

U2 - 10.1093/jamia/ocv011

DO - 10.1093/jamia/ocv011

M3 - Article

C2 - 25829460

AN - SCOPUS:84945490735

VL - 22

SP - 1243

EP - 1250

JO - Journal of the American Medical Informatics Association : JAMIA

JF - Journal of the American Medical Informatics Association : JAMIA

SN - 1067-5027

IS - 6

ER -