Currently, clinicians using EHRs encounter numerous alerts as they navigate computerized prescribing for their patients. While these alerts are critical for patient safety, they are often overridden or ignored due to alert fatigue.
An estimated 90 percent of drug interaction alerts are ineffective, as they temporarily halt prescribing with generic warning imagery and brief messaging, but do not offer user-friendly interfaces with advice that can help the prescriber.
The National Science Foundation (NSF) www.nsf.gov within their “Smart and Connected Health Program”, has provided funds for $605,572 to Indiana University-Purdue University Indianapolis (IUPUI) www.iupui.edu to advance knowledge in Human Computer Interaction (HCI) that will help to design, develop, and implement information technologies for optimal use by a target audience.
According to Jon Duke, Director of Drug Safety Informatics at Regenstrief Institute www.regenstrief.org, “Although physicians routinely encounter drug-drug interaction alerts during daily medication prescribing, the effectiveness of such alerts remains extremely low.”
An additional barrier to the desired effect of alerts is that healthcare providers may be wary of using computerized advice in the same way they would trust advice from medical literature or peer providers.
A crucial step in transforming the design of drug-drug interaction alerts involves studying the types and sources of information that providers deem important and impactful. The team directly observed hospital team meetings. Next, they constructed work models to identify the themes that drive trusted advice in clinical settings.
The research team is now using this knowledge to transform the computer interface to reflect various models of alerts. The team is also developing novel interface designs where computer alerts can send drug safety guidance in various forms, including changes in the tone from danger-based tones to supportive ones.
Design ideas include visualizations for different alert messages. The team is going to test and evaluate the different alerts in the lab and in hospital environments to determine the effect on prescriber responses. They will also elicit healthcare provider feedback on the visual aspects and impact of the alerts.
“This innovative Human Computer Interaction project illustrates how studying novel visualizations and design can better integrate information that is meaningful to clinicians and maximize the potential of computerized alerts to improve safety,” said Wendy Nilsen, Smart and Connected health Program Director at NSF.
The broader impacts of this project are numerous. The team believes that translating their research findings into real world EMR systems could improve the user experience of prescribers and yield a potential reduction in the millions of adverse drug events that occur each year.