Critical Drug-Drug Interactions for Use in Electronic Health Records Systems With Computerized Physician Order Entry

2011 ◽  
Vol 7 (2) ◽  
pp. 61-65 ◽  
Author(s):  
David C. Classen ◽  
Shobha Phansalkar ◽  
David W. Bates
2021 ◽  
Vol 12 (03) ◽  
pp. 484-494
Author(s):  
Swaminathan Kandaswamy ◽  
Zoe Pruitt ◽  
Sadaf Kazi ◽  
Jenna Marquard ◽  
Saba Owens ◽  
...  

Abstract Objective The aim of this study was to investigate (1) why ordering clinicians use free-text orders to communicate medication information; (2) what risks physicians and nurses perceive when free-text orders are used for communicating medication information; and (3) how electronic health records (EHRs) could be improved to encourage the safe communication of medication information. Methods We performed semi-structured, scenario-based interviews with eight physicians and eight nurses. Interview responses were analyzed and grouped into common themes. Results Participants described eight reasons why clinicians use free-text medication orders, five risks relating to the use of free-text medication orders, and five recommendations for improving EHR medication-related communication. Poor usability, including reduced efficiency and limited functionality associated with structured order entry, was the primary reason clinicians used free-text orders to communicate medication information. Common risks to using free-text orders for medication communication included the increased likelihood of missing orders and the increased workload on nurses responsible for executing orders. Discussion Clinicians' use of free-text orders is primarily due to limitations in the current structured order entry design. To encourage the safe communication of medication information between clinicians, the EHR's structured order entry must be redesigned to support clinicians' cognitive and workflow needs that are currently being addressed via the use of free-text orders. Conclusion Clinicians' use of free-text orders as a workaround to insufficient structured order entry can create unintended patient safety risks. Thoughtful solutions designed to address these workarounds can improve the medication ordering process and the subsequent medication administration process.


2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Rion Brattig Correia ◽  
Luciana P. de Araújo Kohler ◽  
Mauro M. Mattos ◽  
Luis M. Rocha

2019 ◽  
Vol 26 (2) ◽  
pp. 1455-1464
Author(s):  
David Gefen ◽  
Ofir Ben-Assuli ◽  
Nir Shlomo ◽  
Noreen Robertson ◽  
Robert Klempfner

Adalat (Nifedipine) is a calcium-channel blocker that is also used as an antihypertensive drug. The drug was approved by the US Food and Drug Administration in 1985 but was discontinued in 1996 on account, among other things, of interactions with other medications. Nonetheless, Adalat is still used in other countries to treat congestive heart failure. We examine all the congestive heart failure electronic health records of the largest medical center in Israel to discover whether, possibly, taking Adalat with other medications is associated with patient death. This study examines a semantic space built by running latent semantic analysis on the entire corpus of congestive heart failure electronic health records of that medical center, encompassing 8 years of data on almost 12,000 patients. Through this semantic space, the most highly correlated medications and medical conditions that co-occurred with Adalat were identified. This was done separately for men and women. The results show that Adalat is correlated with different medications and conditions across genders. The data also suggest that taking Adalat with Captopril (angiotensin-converting enzyme inhibitor) or Rulid (antibiotic) might be dangerous in both genders. The study thus demonstrates the potential of applying latent semantic analysis to identify potentially dangerous drug interactions that may have otherwise gone under the radar.


2016 ◽  
Vol 25 (01) ◽  
pp. 7-12 ◽  
Author(s):  
A. Wright ◽  
J. Ash ◽  
H. Singh ◽  
D. F. Sittig

SummaryAlthough the health information technology industry has made considerable progress in the design, development, implementation, and use of electronic health records (EHRs), the lofty expectations of the early pioneers have not been met. In 2006, the Provider Order Entry Team at Oregon Health & Science University described a set of unintended adverse consequences (UACs), or unpredictable, emergent problems associated with computer-based provider order entry implementation, use, and maintenance. Many of these originally identified UACs have not been completely addressed or alleviated, some have evolved over time, and some new ones have emerged as EHRs became more widely available. The rapid increase in the adoption of EHRs, coupled with the changes in the types and attitudes of clinical users, has led to several new UACs, specifically: complete clinical information unavailable at the point of care; lack of innovations to improve system usability leading to frustrating user experiences; inadvertent disclosure of large amounts of patient-specific information; increased focus on computer-based quality measurement negatively affecting clinical workflows and patient-provider interactions; information overload from marginally useful computer-generated data; and a decline in the development and use of internally-developed EHRs. While each of these new UACs poses significant challenges to EHR developers and users alike, they also offer many opportunities. The challenge for clinical informatics researchers is to continue to refine our current systems while exploring new methods of overcoming these challenges and developing innovations to improve EHR interoperability, usability, security, functionality, clinical quality measurement, and information summarization and display.


Drug Safety ◽  
2015 ◽  
Vol 38 (9) ◽  
pp. 799-809 ◽  
Author(s):  
Yannick Girardeau ◽  
Claire Trivin ◽  
Pierre Durieux ◽  
Christine Le Beller ◽  
Lillo-Le Louet Agnes ◽  
...  

2014 ◽  
Vol 10 (1) ◽  
pp. 59-63 ◽  
Author(s):  
Marvin B. Harper ◽  
Christopher A. Longhurst ◽  
Troy L. McGuire ◽  
Rod Tarrago ◽  
Bimal R. Desai ◽  
...  

2012 ◽  
Vol 20 (3) ◽  
pp. 489-493 ◽  
Author(s):  
Shobha Phansalkar ◽  
Heleen van der Sijs ◽  
Alisha D Tucker ◽  
Amrita A Desai ◽  
Douglas S Bell ◽  
...  

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