Best practices for preventing malfunctions in rule-based clinical decision support alerts and reminders: Results of a Delphi study

International Journal of Medical Informatics
Adam WrightDean F Sittig

Abstract

Developing effective and reliable rule-based clinical decision support (CDS) alerts and reminders is challenging. Using a previously developed taxonomy for alert malfunctions, we identified best practices for developing, testing, implementing, and maintaining alerts and avoiding malfunctions. We identified 72 initial practices from the literature, interviews with subject matter experts, and prior research. To refine, enrich, and prioritize the list of practices, we used the Delphi method with two rounds of consensus-building and refinement. We used a larger than normal panel of experts to include a wide representation of CDS subject matter experts from various disciplines. 28 experts completed Round 1 and 25 completed Round 2. Round 1 narrowed the list to 47 best practices in 7 categories: knowledge management, designing and specifying, building, testing, deployment, monitoring and feedback, and people and governance. Round 2 developed consensus on the importance and feasibility of each best practice. The Delphi panel identified a range of best practices that may help to improve implementation of rule-based CDS and avert malfunctions. Due to limitations on resources and personnel, not everyone can implement all best practices. ...Continue Reading

Citations

Dec 24, 2018·Nursing Education Perspectives·Karen H Frith
Jul 23, 2019·Journal of the American Medical Informatics Association : JAMIA·Adam WrightDean F Sittig
Nov 10, 2020·International Journal of Clinical Pharmacy·Fahad AlshahraniAnthony R Cox
Jan 16, 2021·Journal of the American Medical Informatics Association : JAMIA·Carolyn PetersenAdam Wright
Mar 12, 2021·Applied Clinical Informatics·Adam WrightDean F Sittig

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