Abstract
We developed and evaluated a system to automatically identify serious clinical conditions in inpatients. The system notifies the patient's covering physician via his pager that an alert is present and offers potential therapies for the patient's condition (action items) at the time he views the alert information. Over a 6 month period, physicians responded to 1214 (70.2%) of 1730 alerts for which they were paged; they responded to 1002 (82.5% of the 1214) in less than 15 minutes. They said they would take action in 71.5% of the alerts, and they placed an order directly from the alert display screen in 39.4%. Further study is needed to determine if this alerting system improves processes or outcomes of care.
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Selected References
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- Bates D. W., O'Neil A. C., Boyle D., Teich J., Chertow G. M., Komaroff A. L., Brennan T. A. Potential identifiability and preventability of adverse events using information systems. J Am Med Inform Assoc. 1994 Sep-Oct;1(5):404–411. doi: 10.1136/jamia.1994.95153428. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hiltz F. L., Teich J. M. Coverage List: a provider-patient database supporting advanced hospital information services. Proc Annu Symp Comput Appl Med Care. 1994:809–813. [PMC free article] [PubMed] [Google Scholar]
- Kuperman G. J., Teich J. M., Bates D. W., McLatchey J., Hoff T. G. Representing hospital events as complex conditionals. Proc Annu Symp Comput Appl Med Care. 1995:137–141. [PMC free article] [PubMed] [Google Scholar]
- Lundberg G. D. Critical (panic) value notification: an established laboratory practice policy (parameter) JAMA. 1990 Feb 2;263(5):709–709. [PubMed] [Google Scholar]
- Rind D. M., Safran C., Phillips R. S., Wang Q., Calkins D. R., Delbanco T. L., Bleich H. L., Slack W. V. Effect of computer-based alerts on the treatment and outcomes of hospitalized patients. Arch Intern Med. 1994 Jul 11;154(13):1511–1517. [PubMed] [Google Scholar]
- Safran C., Slack W. V., Bleich H. L. Role of computing in patient care in two hospitals. MD Comput. 1989 May-Jun;6(3):141–148. [PubMed] [Google Scholar]
- Tate K. E., Gardner R. M., Scherting K. Nurses, pagers, and patient-specific criteria: three keys to improved critical value reporting. Proc Annu Symp Comput Appl Med Care. 1995:164–168. [PMC free article] [PubMed] [Google Scholar]
- Tate K. E., Gardner R. M., Weaver L. K. A computerized laboratory alerting system. MD Comput. 1990 Sep-Oct;7(5):296–301. [PubMed] [Google Scholar]
- Teich J. M., Spurr C. D., Flammini S. J., Schmiz J., Beckley R. F., Hurley J. F., Aranow M., Glaser J. P. Response to a trial of physician-based inpatient order entry. Proc Annu Symp Comput Appl Med Care. 1993:316–320. [PMC free article] [PubMed] [Google Scholar]