| Potential Safety Gaps in Order Entry and Automated Drug Alerts: A Nationwide Survey of VA Physician Self-Reported Practices With Computerized Order Entry. | |
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MedLine Citation:
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PMID: 21666510 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE:: Understanding provider perceptions of and experiences with order entry and order checks (drug alerts) in an electronic prescribing system may help improve medication safety technology. DESIGN:: Cross-sectional, national survey of Veterans Administration physicians practicing in various specialties. MEASUREMENT:: Thirty-five question instrument was divided into 4 content domains. Response options included dichotomous, numeric, multiple choices, and Likert-like scales. Statistical methods included logistic regression. RESULTS:: The adjusted response rate was 1543 of 3588 (43%). Almost all providers (90%) felt that the VA electronic prescribing system, including its order checks, improved prescribing safety to some degree. Most respondents (72%) reported that they always or almost always document outside medications in a clinic note, although only 44% always or almost always entered outside medications in the non-VA medication data field. Most physicians (88%) who encountered serious allergic or adverse drug reactions reported either notifying a pharmacist or entering the information in the allergies/adverse reactions field. Generalists and physicians with higher numbers of prescriptions were more likely to enter relevant data into the electronic medical record (or notify a pharmacist, in the case of adverse reactions). In addition, 48% of providers described critical drug-drug interaction alerts as very useful; medical specialists found these less useful, whereas surgical specialists found these more useful when compared with generalists. LIMITATIONS:: Survey was conducted within a single healthcare system. CONCLUSION:: Computerized provider order entry and related order checks are perceived to improve prescribing safety; however, provider entry of some relevant information into the appropriate electronic fields may not be optimal. |
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Authors:
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Jeffrey Spina; Peter A Glassman; Barbara Simon; Andrew Lanto; Martin Lee; Francesca Cunningham; Chester B Good |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-6-9 |
Journal Detail:
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Title: Medical care Volume: - ISSN: 1537-1948 ISO Abbreviation: - Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-6-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0230027 Medline TA: Med Care Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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*VA Greater Los Angeles Healthcare System †David Geffen School of Medicine, University of California Los Angeles, Los Angeles ‡VA HSR&D Center for the Study of Healthcare Provider Behavior §VA Center for Medication Safety, Hines, IL ∥Biostatistics, School of Public Health & David Geffen School of Medicine, University of California Los Angeles, CA ¶VA Pharmacy Benefits Management Service, Hines, IL ♯Pittsburgh VA Medical Center, Pittsburgh, PA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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