Effect of knowledgebase transition of a clinical decision support system on medication order and alert patterns in an emergency department

被引：0

作者：

Jung, Weon ^{[1
]}

Yu, Jaeyong ^{[1
]}

Park, Hyunjung ^{[1
]}

Chae, Minjung Kathy ^{[1
]}

Lee, Sang Seob ^{[2
]}

Choi, Jong Soo ^{[1
,2
]}

Kang, Mira ^{[1
,2
,3
]}

Chang, Dong Kyung ^{[1
,2
,4
]}

Cha, Won Chul ^{[1
,2
,5
]}

机构：

[1] Sungkyunkwan Univ, Samsung Adv Inst Hlth Sci & Technol SAIHST, Dept Digital Hlth, Seoul 06351, South Korea

[2] Samsung Med Ctr, Digital Innovat Ctr, Seoul 06351, South Korea

[3] Sungkyunkwan Univ, Sch Med, Ctr Hlth Promot, Samsung Med Ctr, Seoul 06351, South Korea

[4] Sungkyunkwan Univ, Samsung Med Ctr, Dept Gastroenterol, Sch Med, Seoul 06351, South Korea

[5] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Emergency Med, 81 Irwon Ro, Seoul 06351, South Korea

来源：

SCIENTIFIC REPORTS | 2023年 / 13卷 / 01期

关键词：

ELECTRONIC HEALTH RECORD; CHALLENGES; PITFALLS;

D O I：

10.1038/s41598-023-40188-4

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

A knowledgebase (KB) transition of a clinical decision support (CDS) system occurred at the study site. The transition was made from one commercial database to another, provided by a different vendor. The change was applied to all medications in the institute. The aim of this study was to analyze the effect of KB transition on medication-related orders and alert patterns in an emergency department (ED). Data of patients, medication-related orders and alerts, and physicians in the ED from January 2018 to December 2020 were analyzed in this study. A set of definitions was set to define orders, alerts, and alert overrides. Changes in order and alert patterns before and after the conversion, which took place in May 2019, were assessed. Overall, 101,450 patients visited the ED, and 1325 physicians made 829,474 prescription orders to patients during visit and at discharge. Alert rates (alert count divided by order count) for periods A and B were 12.6% and 14.1%, and override rates (alert override count divided by alert count) were 60.8% and 67.4%, respectively. Of the 296 drugs that were used more than 100 times during each period, 64.5% of the drugs had an increase in alert rate after the transition. Changes in alert rates were tested using chi-squared test and Fisher's exact test. We found that the CDS system knowledgebase transition was associated with a significant change in alert patterns at the medication level in the ED. Careful consideration is advised when such a transition is performed.

引用

页数：10

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