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Development of computer aided decision support and EHR alerts for DOAC prescribing

开发用于 DOAC 处方的计算机辅助决策支持和 EHR 警报

基本信息

批准号：
10059571
负责人：
Geoffrey Douglas Barnes
金额：
$ 7.8万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-21 至 2022-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10059571
关键词：
Address Adverse drug event Adverse event American Anticoagulants Anticoagulation Atrial Fibrillation Behavior Cardiovascular system Cessation of life Characteristics Clinic Visits Clinical Clinical Trials Computer Assisted Computer Models Computers Coronary heart disease Data Decision Making Decision Support Systems Development Diagnosis Diagnostic Dose Drug Interactions Drug Prescriptions Electronic Health Record Ethnography Evaluation Event FDA approved Fatigue Foundations Frequencies Grant Group Practice Heart failure Hemorrhage Hospitalization Interview Label Laboratories Medication Errors Michigan Modeling Notification Oral Patients Persons Pharmaceutical Preparations Provider Psyche structure Renal function Rights Risk Specific qualifier value Structure System Testing Therapeutic Time United States Agency for Healthcare Research and Quality Visit Work base behavior change clinical care clinical decision support compare effectiveness design follow-up heuristics improved medication safety novel safe patient support tools tool usability user centered design venous thromboembolism

项目摘要

Project Summary/Abstract This study will develop, assess usability of, and refine a a “diagnosis-driven” computer decision support system (CDS) and a longitudinal alert system to improve safe and patient-specific prescribing of direct oral anticoagulant (DOAC) medications. We will develop diagnosis-driven CDS tools for the two most common conditions leading to DOAC use (atrial fibrillation and venous thromboembolism). Each will guide the clinician through drug and dose selection based on critical patient characteristics, laboratory values, and concurrent medication use. User-center design principles will underly an iterative approach of heuristic evaluation, usability testing, and semi-structured interviews with 15 practicing clinicians. We will also develop a serial, longitudinal system to continually re-assess DOAC prescribing appropriateness and alert clinicians when issues develop. Following the “5 Rights” model endorsed by AHRQ, we will assess for the most acceptable format, channel, and time in clinician work flor for these alert notifications to occur. Findings from this study will lead to improvements in safe management and a reduction in adverse drug events for the three million patients prescribed DOACs nationwide.

项目概要/摘要这项研究将开发、评估可用性并完善“诊断驱动”计算机决策支持系统（CDS）和纵向警报系统，以提高直接口服药物的安全性和针对患者的具体处方抗凝（DOAC）药物。我们将为两个最常见的领域开发诊断驱动的 CDS 工具导致使用 DOAC 的病症（心房颤动和静脉血栓栓塞）。每个人都会指导临床医生根据关键患者特征、实验室值和并发情况选择药物和剂量药物使用。以用户为中心的设计原则将成为启发式评估迭代方法的基础，可用性测试以及对 15 名执业临床医生的半结构化访谈。我们还将开发一个系列，纵向系统不断重新评估 DOAC 处方的适当性，并在何时提醒临床医生问题的发展。遵循 AHRQ 认可的“5 项权利”模式，我们将评估最可接受的这些警报通知发生的格式、渠道和临床医生工作时间。这项研究的结果将改善 300 万患者的安全管理并减少药物不良事件全国范围内规定了 DOAC。