Developing and implementing clinical decision support for use in a computerized prescriber-order-entry system

Chaffee, Bruce W.; Zimmerman, Christopher R.
March 2010
American Journal of Health-System Pharmacy;3/1/2010, Vol. 67 Issue 5, p391
Academic Journal
Purpose. The development and implementation of clinical decision support (CDS) in a computerized prescriber-order-entry (CPOE) system in a large, tertiary care, academic health care system are described. Summary. CDS is generally considered to be a key factor in promoting successful system adoption, patient safety, and positive patient outcomes for CPOE implementation. The impact of CDS depends on the methods used by the institution to implement CPOE using both passive and active system design features. At the University of Michigan Health System, interdisciplinary project teams were assembled to plan, build, and implement the CDS component of CPOE using several underlying fundamental principles to ensure the usability and safety of the system, including standardization of system configuration, workflow design, and prioritization of the number and types of interruptive alerts that would be deployed. Passive CDS rules were established for nomenclature, links to information, relevant results, and order sets. Active CDS rules were developed for noninterruptive alerts (patient list alert flags and form-called medical logic modules) and interruptive alerts, including alerts for allergies, dose checks, drug-drug interactions, drug-food interactions, and drug-disease interactions. The institution provided sufficient staffing and institutional governance to implement and sustain CDS. Conclusion. Through an interdisciplinary collaboration, an academic health care system planned, designed, and implemented institution-specific, CPOE-integrated CDS to improve clinical efficiency and facilitate the compliance with regulatory policies and guidelines.


Related Articles

  • Communicating information to patients about medicine. Gibbs, S.; Waters, W. E.; George, C. F. // Journal of the Royal Society of Medicine;May1990, Vol. 83 Issue 5, p292 

    Three thousand four hundred and ten patients recruited at 254 pharmacies took part in a national postal survey of the effect of prescription information leaflets. The patients had been prescribed penicillins, non-steroidal anti-inflammatory drugs (NSAIDs) or β-adrenoceptor antagonists. The...

  • IS YOUR PARENT OVER-MEDICATED? Carpenter, Siri // Prevention;Dec2008, Vol. 60 Issue 12, p142 

    The article discusses overmedication in elderly people. The author discusses her experience with her mother who developed memory problems while taking several drugs. She explains that polypharmacy is common among older people. Problems and side effects including adverse drug events caused by...

  • Monitoring for adverse drug events. Kennedy, Dianne L.; Goldman, Stephen A. // American Family Physician;11/1/1997, Vol. 56 Issue 7, p1718 

    Editorial. Provides information on monitoring adverse reactions associated with the use of drugs and other medical products. Guidelines for family physicians when prescribing drugs to patient; How to provide health professionals with the most up-to-date information on drug safety.

  • Current explicit criteria offer little consensus on which medications are potentially inappropriate in older adults.  // Drugs & Therapy Perspectives;Apr2011, Vol. 27 Issue 4, p23 

    Explicit criteria for potentially inappropriate medications in older adults have been developed to attempt to reduce the incidence of adverse drug reactions and improve health outcomes in this patient population. The existing criteria differ in their characteristics and often in their statements...

  • Iatrogenic Prescribing in Acute Care: Learning From Our Mistakes. MacDonald, Frank // Journal of Gerontological Nursing;Mar2004, Vol. 30 Issue 3, p20 

    Discusses the process of prescribing medications for older adults. Pharmacokinetics and age-related changes; Potential for adverse drug affects and drug-drug interactions; Problems of older adults that make medication practice difficult; Approaches to improve the medication prescribing practice...

  • Adverse drug reactions. Innes, Alison // Practice Nurse;9/8/2006, Vol. 32 Issue 4, p25 

    The article provides information on adverse drug reactions (ADR) and the role of prescribers to recognize and report them. Unwanted effects are more common in older patients as they may have altered drug handling. In neonates, particularly premature babies, several of the enzymes that play a...

  • Ethinylestradiol/drospirenone: potential for interactions in the US.  // PharmacoEconomics & Outcomes News;12/15/2007, Issue 543, p8 

    The article discusses research being done on the concomitant prescribing of ethinyl estradiol/drospirenone and potentially interacting drugs. It references a study by M. McAdams and colleagues published in the October 2007 issue of "Contraception." For evidence of prescriptions for...

  • polypharmacy. Peters, Michael // BMA A-Z Family Medical Encyclopedia;2004, p618 

    A definition of the term "polypharmacy" is presented. It refers to the practice of prescribing several drugs to one person at the same time. Combinations of drugs may be more effective than single drugs. However, it increases the risk of drug interactions which may lead to the risk of adverse...

  • Effort to increase prescription monitoring by physicians.  // Geriatrics;Mar1991, Vol. 46 Issue 3, p20 

    The article reports that a 75% increase in the number of physicians who monitor prescription and over-the-counter medications prescription and over-the-counter medications for patients over 65 is the goal of the U.S. Public Health Service Office of Disease Prevention and Health Promotion. A...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics