Shobha Phansalkar

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The objective of this review is to describe the implementation of human factors principles for the design of alerts in clinical information systems. First, we conduct a review of alarm systems to identify human factors principles that are employed in the design and implementation of alerts. Second, we review the medical informatics literature to provide(More)
OBJECTIVE To develop a set of high-severity, clinically significant drug-drug interactions (DDIs) for use in electronic health records (EHRs). METHODS A panel of experts was convened with the goal of identifying critical DDIs that should be used for generating medication-related decision support alerts in all EHRs. Panelists included medication knowledge(More)
Informatics tools to extract and analyze clinical information on patients have lagged behind data-mining developments in bioinformatics. While the analyses of an individual's partial or complete genotype is nearly a reality, the phenotypic characteristics that accompany the genotype are not well known and largely inaccessible in free-text patient health(More)
OBJECTIVE Alert fatigue represents a common problem associated with the use of clinical decision support systems in electronic health records (EHR). This problem is particularly profound with drug-drug interaction (DDI) alerts for which studies have reported override rates of approximately 90%. The objective of this study is to report consensus-based(More)
BACKGROUND Clinical decision support systems can prevent knowledge-based prescription errors and improve patient outcomes. The clinical effectiveness of these systems, however, is substantially limited by poor user acceptance of presented warnings. To enhance alert acceptance it may be useful to quantify the impact of potential modulators of acceptance. (More)
PURPOSE Implementation of evidence-based techniques, such as explicit computerized protocols, has achieved limited success among clinicians. In this study, we describe the development and validation of an instrument for assessing clinicians' perceptions about use of explicit computerized protocols. METHODS Qualitative assessment of semi-structured(More)
Previous studies have described the determinants of successful information technology (IT) implementation. In 2003, Kukafka et al. integrated several theoretical perspectives and proposed a framework for IT implementation. This framework is applicable to IT implementation in general but lacks the identification of factors affecting adoption, which are(More)
OBJECTIVE To establish preferred strategies for presenting drug-drug interaction (DDI) clinical decision support alerts. MATERIALS AND METHODS A DDI Clinical Decision Support Conference Series included a workgroup consisting of 24 clinical, usability, and informatics experts representing academia, health information technology (IT) vendors, healthcare(More)
BACKGROUND High override rates for drug-drug interaction (DDI) alerts in electronic health records (EHRs) result in the potentially dangerous consequence of providers ignoring clinically significant alerts. Lack of uniformity of criteria for determining the severity or validity of these interactions often results in discrepancies in how these are evaluated.(More)