TY - JOUR
T1 - The nature and variability of automated practice alerts derived from electronic health records in a U.S. nationwide critical care research network
AU - Benthin, Cody
AU - Pannu, Sonal
AU - Khan, Akram
AU - Gong, Michelle
N1 - Publisher Copyright:
Copyright © 2016 by the American Thoracic Society.
PY - 2016/10
Y1 - 2016/10
N2 - Rationale: The nature, variability, and extent of early warning clinical practice alerts derived from automated query of electronic health records (e-alerts) currently used in acute care settings for clinical care or research is unknown. Objectives: To describe e-alerts in current use in acute care settings at medical centers participating in a nationwide critical care research network. Methods: We surveyed investigators at 38 institutions involved in the National Institutes of Health-funded Clinical Trials Network for the Prevention and Early Treatment of Acute Lung Injury (PETAL) for quantitative and qualitative analysis. Measurements and Main Results: Thirty sites completed the survey (79% response rate). All sites used electronic health record systems. Epic Systems was used at 56% of sites; the others used alternate commercially available vendors or homegrown systems. Respondents at 57% of sites represented in this survey used e-alerts. All but 1 of these 17 sites used an e-alert for early detection of sepsisrelated syndromes, and 35% used an e-alert for pneumonia. E-alerts were triggered by abnormal laboratory values (37%), vital signs (37%), or radiology reports (15%) and were used about equally for clinical decision support and research. Only 59% of sites with e-alerts have evaluated them either for accuracy or for validity. Conclusions:Amajority of the research network sites participating in this survey use e-alerts for early notification of potential threats to hospitalized patients; however, there was significant variability in the nature of e-alerts between institutions. Use of onecommon electronic health record vendor at more than half of the participating sites suggests that it may be possible to standardize e-alerts across multiple sites in research networks, particularly among sites using the same medical record platform.
AB - Rationale: The nature, variability, and extent of early warning clinical practice alerts derived from automated query of electronic health records (e-alerts) currently used in acute care settings for clinical care or research is unknown. Objectives: To describe e-alerts in current use in acute care settings at medical centers participating in a nationwide critical care research network. Methods: We surveyed investigators at 38 institutions involved in the National Institutes of Health-funded Clinical Trials Network for the Prevention and Early Treatment of Acute Lung Injury (PETAL) for quantitative and qualitative analysis. Measurements and Main Results: Thirty sites completed the survey (79% response rate). All sites used electronic health record systems. Epic Systems was used at 56% of sites; the others used alternate commercially available vendors or homegrown systems. Respondents at 57% of sites represented in this survey used e-alerts. All but 1 of these 17 sites used an e-alert for early detection of sepsisrelated syndromes, and 35% used an e-alert for pneumonia. E-alerts were triggered by abnormal laboratory values (37%), vital signs (37%), or radiology reports (15%) and were used about equally for clinical decision support and research. Only 59% of sites with e-alerts have evaluated them either for accuracy or for validity. Conclusions:Amajority of the research network sites participating in this survey use e-alerts for early notification of potential threats to hospitalized patients; however, there was significant variability in the nature of e-alerts between institutions. Use of onecommon electronic health record vendor at more than half of the participating sites suggests that it may be possible to standardize e-alerts across multiple sites in research networks, particularly among sites using the same medical record platform.
KW - Acute respiratory distress syndrome
KW - Electronic health record alerts
KW - Sepsis
KW - Survey
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U2 - 10.1513/AnnalsATS.201603-172BC
DO - 10.1513/AnnalsATS.201603-172BC
M3 - Article
C2 - 27404288
AN - SCOPUS:84992579911
SN - 2325-6621
VL - 13
SP - 1784
EP - 1788
JO - Annals of the American Thoracic Society
JF - Annals of the American Thoracic Society
IS - 10
ER -