Showing Your Work: Impact of annotating electronic prescriptions with decision support results.
Showing Your Work: Impact of annotating electronic prescriptions with decision support results.
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展示您的工作：用决策支持结果注释电子处方的影响。
DOI：
10.1016/j.jbi.2009.11.008
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发表时间：
2010
影响因子：
4.5
通讯作者：
Davison,Coda
中科院分区：
文献类型：
--
作者：
Johnson,KevinB;Ho,Yun-Xian;Cala,CatherMarie;Davison,Coda
具有决策支持的电子处方系统并不定期地向药剂师传达关于开处方者的决策的足够量的信息。为了解决电子处方流程中的这种沟通差距，我们实施了一个名为“显示您的工作”（SYW）的系统，该系统可以向电子处方系统生成的电子处方添加警报和覆盖评论。为了评估该系统的定量影响，我们进行了一项随机、双盲、对照研究，以评估药房回叫率和类型，并发现注释的任何意外后果。每天，整个企业的SYW输出都随机地为所有电子处方打开或关闭。一个方便的样本，三个药店，不知道SYW的状态，每天提交回调日志。这些日志用于计算回调的速率和原因。在研究结束时，我们调查了我们地区最常用的50家药店，以评估SYW对满意度和沟通的影响。共发生了202次回调，SYW“开”日的回调率为45次回调/1000张处方，“关”日的回调率为40次回调/1000张处方（p=0.4）。我们收到了38份调查（76%的回复率），其中33名受访者对SYW发表了评论。大多数受访者（69%）同意SYW对回电有积极影响，尤其是儿科处方（82%）。评论表明，SYW在必要时增加回调，在其他情况下减少回调，但不会导致不必要的回调。这些研究结果支持持续和潜在的扩大使用SYW的电子处方系统，以加强与药剂师的沟通。
e-Prescribing systems with decision support do not routinely communicate an adequate amount of information regarding the prescribers’ decision to pharmacists. To address this communication gap in the e-prescribing process, we implemented a system called Show Your Work (SYW) that appends alerts and override comments to e-prescriptions generated by an e-prescribing system. To assess the quantitative impact of this system, we conducted a randomized, double-blinded, controlled study to assess pharmacy callback rates and types, and to uncover any unintended consequences of the annotations. Each day, SYW output across the enterprise was turned “on” or “off” randomly for all e-prescriptions. A convenience sample of three pharmacies, blinded to SYW status, submitted callback logs each day. These logs were used to calculate the rate of and reason for callbacks. At the conclusion of the study, we surveyed the 50 most frequently used pharmacies in our area to assess the impact of SYW on satisfaction and communication. A total of 202 callbacks had occurred yielding a callback rate of 45 callbacks/1000 prescriptions for SYW “on” days and 40 callbacks/1000 prescriptions for “off” days (p=0.4). We received 38 surveys (76% response rate) with 33 respondents commenting about SYW. Most respondents agreed (69%) that SYW favorably impacted callbacks—especially with pediatric prescriptions (82%). Comments suggested that SYW increased callbacks where necessary and decreased them in other situations, but did not contribute to unnecessary callbacks. These findings support the continued and potentially expanded use of SYW by e-prescribing systems to enhance communication with pharmacists.