Methods Inf Med 2013; 52(02): 109-127
DOI: 10.1055/s-0038-1627055
Original Articles
Schattauer GmbH

Discussion of “Attitude of Physi -cians Towards Automatic Alerting in Computerized Physician Order Entry Systems”

D. W. Bates
1   Centre for Patient Safety Research and Practice, Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, Massachusetts, USA
,
M. T. Baysari
2   Australian Institute of Health Innovation, Faculty of Medicine, University of New South Wales, Sydney, Australia
3   Department of Clinical Pharmacology & Toxicology, St Vincent’s Hospital, Sydney, Australia
,
M. Dugas
4   Institute of Medical Informatics, University of Münster, Münster, Germany
,
W. E. Haefeli
5   Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany
,
A. W. Kushniruk
6   School of Health Information Science, University of Victoria, Victoria, Canada
,
C. U. Lehmann
7   Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA
,
J. Liu
8   Department of Medical Informatics, West China Hospital/West China Medical School, Sichuan University, Chengdu, China
9   Department of Otolaryngology, West China Hospital/West China Medical School, Sichuan University, Chengdu, China
,
J. Mantas
10   Health Informatics Laboratory, University of Athens, Athens, Greece
,
A. Margolis
11   Instituto de Computación, Facultad de Ingeniería, Universidad de la República, Montevideo, Uruguay
,
K. Miyo
12   Department of Planning, Information and Management, The University of Tokyo Hospital, Tokyo, Japan
,
C. Nohr
13   Danish Centre for Health Informatics, Department of Development and Planning, Aalborg University, Aalborg, Denmark
,
M. Peleg
14   Department of Information Systems, University of Haifa, Haifa, Israel
,
F. G. B. de Quirós
15   Department of Health Informatics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
,
S. P. Slight
1   Centre for Patient Safety Research and Practice, Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, Massachusetts, USA
16   Division of Primary Care, The University of Nottingham, Nottingham, UK
,
J. Starmer
7   Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA
,
K. Takabayashi
17   Department of Medical Information and Management, Chiba University Hospital, Chiba, Japan
,
J. I. Westbrook
18   Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, University of New South Wales, Sydney, Australia
› Author Affiliations
Further Information

Publication History

Publication Date:
22 January 2018 (online)

With these comments on the paper “Attitude of Physicians Towards Automatic Alerting in Computerized Physician Order Entry Systems”, written by Martin Jung and co authors, with Dr. Elske Ammenwerth as senior author [1], the journal wants to stimulate a broad discussion on computerized physi cian order entry systems. An international group of experts have been invited by the editor of Methods to comment on this paper. Each of the invited commentaries forms one section of this paper.

 
  • References

  • 1 Jung M, Hoerbst A, Hackl W. O, Kirrane F, Borbolla D, Jaspers MW. et al Attitude of Physicians Towards Automatic Alerting in Computerized Physician Order Entry Systems - A Comparative International Survey. Methods Inf Med 2013; 52 (02) 99-108.
  • 2 Shamliyan TA, Duval S, Du J, Kane RL. Just what the doctor ordered. Review of the evidence of the impact of computerized physician order entry system on medication errors. Health Serv Res 2008; 43 1 Pt 1 32-53.
  • 3 Wolfstadt JI, Gurwitz JH, Field TS. et al The effect of computerized physician order entry with clinical decision support on the rates of adverse drug events: a systematic review. J Gen Intern Med 2008; 23 (04) 451-458.
  • 4 Paterno MD, Maviglia SM, Gorman PN. et al Tiering drug-drug interaction alerts by severity increases compliance rates. J Am Med Inform Asso 2009; 16 (01) 40-46.
  • 5 Seidling HM, Phansalkar S, Seger DL. et al Factors influencing alert acceptance: a novel approach for predicting the success of clinical decision support. J Am Med Inform Assoc 2011; 18 (04) 479-484.
  • 6 Phansalkar S, Desai AA, Bell D. et al High-priority drug-drug interactions for use in electronic health records. J Am Med Inform Assoc 2012; 19 (05) 735-743.
  • 7 Phansalkar S, van der Sijs H, Tucker AD. et al Drug-drug interactions that should be non-interruptive in order to reduce alert fatigue in electronic health records. J Am Med Inform Assoc. 2012.
  • 8 Kesselheim AS, Cresswell K, Phansalkar S, Bates DW, Sheikh A. Clinical decision support systems could be modified to reduce ‘alert fatigue’ while still minimizing the risk of litigation. Health Aff (Millwood) 2011; 30 (12) 2310-2317.
  • 9 Cresswell KM, Bates DW, Phansalkar S, Sheikh A. Opportunities and challenges in creating an international centralised knowledge base for clinical decision support systems in ePrescribing. BMJ Qual Saf 2011; 20 (07) 625-630.
  • 10 Baysari MT, Westbrook JI, Richardson KL, Day RO. The influence of computerized decision support on prescribing during ward-rounds: are the decision-makers targeted?. J Am Med Inform Assoc 2011; 18: 754-759.
  • 11 Baysari MT, Reckmann MH, Li L, Day RO, Westbrook JI. Failure to utilize functions of an electronic prescribing system and the subsequent generation of ’technically preventable’ computerized alerts. JAMIA 2012; 19 (06) 1003-1010.
  • 12 van der Sijs H, Aarts J, Gelder TV, Berg M, Vulto A. Turning off frequently overridden drug alerts: Limited opportunities for doing it safely. JAMIA 2008; 15 (04) 439-448.
  • 13 Westbrook JI, Reckmann M, Li L, Runciman WB, Burke R, Lo C, Baysari MT, Braithwaite J, Day RO. Effects of Two Commercial Electronic Prescribing Systems on Prescribing Error Rates in Hospital In-Patients: A Before and After Study. PLoS Med. 2012; 9 (01) e1001164 doi:10.1371/journal.pmed.1001164
  • 14 Black AD, Car J, Pagliari C, Anandan C, Cresswell K, Bokun T, McKinstry B, Procter R, Majeed A, Sheikh A. The impact of eHealth on the quality and safety of health care: a systematic overview. PLoS Med 2011; 8 (01) e1000387 doi: 10.1371/journal.pmed.1000387
  • 15 Kucher N, Koo S, Quiroz R, Cooper JM, Paterno MD, Soukonnikov B, Goldhaber SZ. Electronic alerts to prevent venous thromboembolism among hospitalized patients. N Engl J Med 2005; 352 (10) 969-977.
  • 16 Ahmadian L, van Engen-Verheul M, Bakhshi-Raiez F, Peek N, Cornet R, de Keizer NF. The role of standardized data and terminological systems in computerized clinical decision support systems: literature review and survey. Int J Med Inform 2011; 80 (02) 81-93.
  • 17 Breil B, Kenneweg J, Fritz F, Bruland P, Doods J, Trinczek B, Dugas M. Multilingual Medical Data Models in ODM Format. Applied Clinical Informatics 2012; 3: 276-289.
  • 18 Fritz F, Balhorn S, Riek M, Breil B, Dugas M. Qualitative and quantitative evaluation of EHR-integrated mobile patient questionnaires regarding usability and cost-efficiency. Int J Med Inform 2012; 81 (05) 303-313.
  • 19 Kawamoto K, Houlihan CA, Balas EA, Lobach DF. Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success. BMJ 2005; 330: 765
  • 20 Metzger J, Welebob E, Bates DW, Lipsitz S, Classen DC. Mixed results in the safety performance of computerized physician order entry. Health Aff 2010; 29: 655-663.
  • 21 Seidling HM, Schmitt SPW, Bruckner T, Kaltschmidt J, Pruszydlo M, Senger C, Bertsche T, Walter-Sack I, Haefeli WE. Patient-specific electronic decision support reduces prescription of excessive doses. Qual Saf Health Care 2010; 19: e15
  • 22 Paterson CA, Jacobs D, Rasmussen S, Youngberg SP, McGuinness N. Randomized, open-label, 5-way crossover study to evaluate the pharmacokinetic/pharmacodynamic interaction between furosemide and the non-steroidal anti-inflammatory drugs diclofenac and ibuprofen in healthy volunteers. Int J Clin Pharmacol Ther 2011; 49: 477-490.
  • 23 Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995; 12: 314-333.
  • 24 Yamamoto Y, Inoue Y, Matsuda K, Takahashi Y, Kagawa Y. Influence of concomitant antiepileptic drugs on plasma lamotrigine concentration in adult Japanese epilepsy patients. Biol Pharm Bull 2012; 35: 487-493.
  • 25 Seidling HM, Storch CH, Bertsche T, Senger C, Kaltschmidt J, Walter-Sack I, Haefeli WE. Successful strategy to improve specificity of electronic statin-drug interaction alerts. Eur J Clin Pharmacol 2009; 65: 1149-1157.
  • 26 Garg AX, Adhikari NKJ, McDonald H, Rosas-Arellano MP, Devereaux PJ, Beyene J, Sam J, Haynes RB. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes. A systematic review. JAMA 2005; 293: 1223-1138.
  • 27 Bertsche T, Pfaff J, Schiller P, Kaltschmidt J, Pruszydlo MG, Stremmel W, Walter-Sack I, Haefeli WE, Encke J. Prevention of adverse drug reactions in intensive care patients by a personal intervention based on an electronic clinical decision support system. Intensive Care Med 2010; 36: 665-672.
  • 28 Chuang J-H. Hripcsak G, Heitjan DF. Design and analysis of controlled trials in naturally clustered environments: implications for medical informatics. JAMIA 2002; 9: 230-238.
  • 29 Yu VL, Fagan LM, Wraith SM, Clancey WJ, Scott AC, Hannigan J, Blum RL, Buchanan BG, Cohen SN. Antimicrobial selection by a computer. A blinded evaluation by infectious diseases experts. JAMA 1979; 242: 1279-1282.
  • 30 Tinetti ME, Bogardus Jr ST, Agostini JV. Potential pitfalls of disease-specific guidelines for patients with multiple conditions. N Engl J Med 2004; 351: 2870-2874.
  • 31 Härtter S, Sennewald R, Nehmiz G, Reilly P. Oral bioavailability of dabigatran etexilate (Pradaxa(®)) after co-medication with verapamil in healthy subjects. Br J Clin Pharmacol 2012 Sep 5. (Epub ahead of print).
  • 32 Wayne Frost R, Lasseter KC, Noe AJ, Shamblen EC, Lettieri JT. Effects of aluminum hydroxide and calcium carbonate antacids on the bioavailability of ciprofloxacine. Antimicrob Agents Chemother 1992; 36: 830-832.
  • 33 Rengelshausen J, Göggelmann C, Burhenne J, Riedel K-D. Ludwig J, Weiss J, Mikus G, Walter-Sack I, Haefeli WE. Contribution of increased oral bioavailability and reduced non-glomerular renal clearance of digoxin to the digoxin-clarithromycin interaction. Br J Clin Pharmacol 2003; 56: 32-38.
  • 34 Honkalammi J, Niemi M, Neuvonen PJ, Backman JT. Dose-dependent interaction between gemfibrozil and repaglinide in humans: strong inhibition of CYP2C8 with subtherapeutic gemfibrozil doses. Drug Metab Dispos 2011; 39: 1977-1986.
  • 35 Karimi S, Hough A, Beckey C, Parra D. Results of a safety initiative for patients on concomitant amiodarone and simvastatin therapy in a Veterans Affairs medical center. J Manag Care Pharm 2010; 16: 472-481.
  • 36 Okudaira T, Kotegawa T, Imai H, Tsutsumi K, Nakano S, Ohashi K. Effect of the treatment period with erythromycin on cytochrome P450 3A activity in humans. J Clin Pharmacol 2007; 47: 871-876.
  • 37 Hafner V, Jäger M, Matthée A-K. Ding R, Burhenne J, Haefeli WE, Mikus G. Effect of simultaneous induction and inhibition of CYP3A by St. John’s wort and ritonavir on CYP3A activity. Clin Pharmacol Ther 2010; 87: 191-196.
  • 38 Mikus G, Schöwel V, Drzewinska M, Rengelshausen J, Ding R, Riedel KD, Burhenne J, Weiss J, Thomsen T, Haefeli WE. Potent cytochrome P450 2C19 genotype-related interaction between voriconazole and the cytochrome P450 3A4 inhibitor ritonavir. Clin Pharmacol Ther 2006; 80: 126-135.
  • 39 Gorski JC, Vannaprasaht S, Hamman MA, Ambrosius WT, Bruce MA, Haehner-Daniels B, Hall SD. The effect of age, sex, and rifampin administration on intestinal and hepatic cytochrome P450 3A activity. Clin Pharmacol Ther 2003; 74: 275-287.
  • 40 Palatini P, de Martin S, Pegoraro P, Orlando R. Enzyme inhibition and induction in liver disease. Curr Clin Pharmacol 2008; 3: 56-69.
  • 41 van der Sijs H, Aarts J, Vulto A, Berg M. Overriding of drug safety alerts in computerized physician order entry. JAMIA 2006; 13: 138-147.
  • 42 Campbell EM, Sittig D, Ash J, Guappone KP, Dykstra RH. Types of unintended consequences related to computerized provider order entry. JAMIA 2006; 13: 547-556.
  • 43 Beuscart-Zephir MC, Pelayo S, Anceaux F, Meaux J, Degroisse M, Degoulet P. Impact of CPOE on doctor-nurse cooperation for the medication ordering and administrative process. Int J Med Inform 2005; 74: 629-641.
  • 44 Li A, Kannry JL, Kushniruk A, Chrimes D, McGinn T, Edonyabo D, Mann D. Integrating usability testing and think-aloud protocol analysis with “near-live” clinical simulations in evaluating clinical decision support. Int J Med Inform 2012; 81: 761-772.
  • 45 Wicks Lm Noor S, Rajaratnam V. Altruism and Medicine. BMJ Careers, 2011. Available online at. http://careers.bmj.com/careers/advice/view-article.html?id=20003883. (Last accessed 1/15/2013)
  • 46 Thiemannn DR. Private communication. Johns Hopkins University.
  • 47 Lomotan EA, Michel G, Lin Z, Shiffman RN. How “should” we write guideline recommendations? Interpretation of deontic terminology in clinical practice guidelines: survey of the health services community. Qual Saf Health Care 2010; 19 (06) 509-513.
  • 48 Samal L, Stavroudis TA, Miller RE, Lehmann HP, Lehmann CU. Effect of a Laboratory Result Pager on Provider Behavior in a Neonatal Intensive Care Unit ACI. 2011; 2 (03) 384-394.
  • 49 Fishbein M, Ajzen I. Belief, Attitude, Intention and Behavior: An Introduction to Theory and Research. Reading, MA: Addison-Wesley; 1975.
  • 50 Ash JS, Sittig DF, Campbell EM, Guappone KP, Dykstra RH. Some unintended consequences of clinical decision support systems. AMIA Annu Symp Proc. 2007: 26-30.
  • 51 Kilbridge PM, Welebob EM, Classen DC. Development of the Leapfrog methodology for evaluating hospital implemented inpatient computerized physician order entry systems. Qual Saf Health Care 2006; 15 (02) 81-84.
  • 52 Weingart SN, Toth M, Sands DZ, Aronson MD, Davis RB, Phillips RS. Physicians’ decisions to override computerized drug alerts in primary care. Arch Intern Med 2003; 163 (21) 2625-2631.
  • 53 Taylor L, Tamblyn R. Reasons for physician non-adherence to electronic drug alerts. Proc MedInfo 2004; 107 Pt 1101-1105.
  • 54 Magnus D, Rodgers S, Avery AJ. GPs’ views on computerized drug interaction alerts: questionnaire survey. J Clin Pharm Therap 2002; 27 (05) 377-382.
  • 55 Shah NR, Seger AC, Seger DL, Fiskio JM, Kuperman GJ, Blumenfeld B, Recklet EG, Bates DW, Gandhi TK. Improving acceptance of computerized prescribing alerts in ambulatory care. JAMIA 2006; 13 (01) 5-11.
  • 56 Kuperman GJ, Bobb A, Payne TH, Avery AJ, Gandhi TK, Burns G, Classen DC, Bates DW. Medication-related clinical decision support in computerized provider order entry systems: a review. JAMIA 2007; 14 (01) 29-40.
  • 57 Mintzberg H. The structuring of organizations: a synthesis of the research. Englewood Cliffs, NJ, USA: Prentice-Hall; 1979.
  • 58 Barr VJ, Robinson S, Marin-Link B, Underhill L, Dotts A, Ravensdale D, Salivaras S. The expanded Chronic Care Model: an integration of concepts and strategies from population health promotion and the Chronic Care Model. Hosp Q 2003; 7 (01) 73-82.
  • 59 http://www.healthit.gov/providers-professionals/achieve-meaningful-use/core-measures/cpoe-meaningful-use.
  • 60 Kuperman GJ, Gibson RF. Computer physician order entry: benefits, costs, and issues. Ann Intern Med 2003; 139 (01) 31-39.
  • 61 Shekelle PG, Morton SC, Keeler EB. Costs and benefits of health information technology. Evid Rep Technol Assess (Full Rep) 2006; 132: 1-71.
  • 62 http://www.leapfroggroup.org/media/file/Leapfrog-AHA_FAH_CPOE_Report.pdf.
  • 63 Kaushal R, Jha AK, Franz C, Glaser J, Shetty KD, Jaggi T, Middleton B, Kuperman GJ, Khorasani R, Tanasijevic M, Bates DW. Return on investment for a computerized physician order entry system. JAMIA 2006; 13 (03) 261-266. Epub 2006 Feb 24
  • 64 Frisse ME. Editorial Comment: Comments on Return on Investment (ROI) As It Applies to Clinical Systems. JAMIA 2006; 13: 365-367.
  • 65 Van Rosse F, Maat B, Rademaker CM. et al The effect of computerized physician order entry on medication prescription errors and clinical outcome in pediatric and intensive care: a systematic review. Pediatrics 2009; 123: 1184-1190.
  • 66 Ammenwerth E, Schnell-Inderst P, Machan C. et al The effect of electronic prescribing on medication errors and adverse drug events: a systematic review. JAMIA 2008; 15 (05) 585-600.
  • 67 Miller RA. Medical Diagnostic Decision Support Systems: Past, Present, and Future. JAMIA 1994; 1 (01) 8-27.
  • 68 Buchanan BG, Shortliffe EH. (eds) Rule-Based Expert Systems: The MYCIN Experiments of the Stanford Heuristic Programming Project. Menlo Park, CA: Addison-Wesley; 1984.
  • 69 Miller RA, Pople Jr HE, Myers JD. Internist-1, an experimental computer-based diagnostic consultant for general internal medicine. N Engl J Med 1982; 307 (08) 468-476.
  • 70 Barnett GO, Cimino JJ, Hupp JA. et al DXplain. An evolving diagnostic decision-support system. JAMA 1987; 258 (01) 67-74.
  • 71 Kawazoe Y, Ohe K. An ontology-based Mediator of clinical information for decision support system. Methods Inf Med 2008; 47 (06) 549-559.
  • 72 Eppenga WL, Derijks HJ, Conemans JM. et al Comparison of a basic and an advanced pharmacotherapy-related clinical decision support system in a hospital care setting in the Netherlands. JAMIA 2012; 19 (01) 66-71.
  • 73 Miyo K, Ohe K. Implementation and Evaluation of an On-line Prescription Check System using a Database of Drug Indications. Stud Health Technol Inform 2010; 160 Pt 2 1391
  • 74 Riedmann D, Jung M, Hackl WO. et al Development of a context model to prioritize drug safety alerts in CPOE systems. BMC Med Inform Decis Mak 2011; 11: 35
  • 75 Miyo K, Nittami YS, Kitagawa Y. et al Development of case-based medication alerting and recommender system: a new approach to prevention for medication error. Stud Health Technol Inform 2007; 129 Pt 2) 871-874.
  • 76 Gietzelt M, Goltz U, Grunwald D. et al ARDEN2BYTECODE: A one-pass Arden Syntax compiler for sevice -oriented decision support system based on OSGi platform. Comput Methods Programs Biomed 2012; 106: 114-125.
  • 77 Song B, Huang B, Wolf K. et al A web 2.0 based HL7 Arden syntax Medical Logical Module platform for knowledge creating and sharing: the development of a rule repository for smart home care. Proceedings of the 7th Asia Pacific Association for Medical Informatics (APAMI) 2012 CD-ROM.
  • 78 Seyfang A, Miksch S. Advanced temporal data abstraction for guideline execution. Stud Health Technol Inform 2004; 101: 88-102.
  • 79 Miyo K, Ohe K. Development and Evaluation of a Real-time Medication Alert System with a Database of Drug-Disease Relationships. Jpn J Med Inform Proceedings on 27th Joint Conference on Medical Informatics 2007; 27 suppl 275-276. (in Japanese)
  • 80 Beuscart R, McNair P, Brender J. PSIP consortium. Patient safety through in-telligent procedures in medication: the PSIP project. Stud Health Technol Inform 2009; 148: 6-13.
  • 81 Ammenwerth E, Hackl WO, Binzer K, Christoffersen TE, Jensen S, Lawton K, Skjoet P, Nohr C. Simulation Studies for the evaluation of health information technologies: experiences and results. HIM J 2012; 41 (02) 14-21.
  • 82 Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn’t. BMJ 1996; 312 7023 71-72.
  • 83 Ben-Asher N, Meyer J, Möller S, Englert R. An Experimental System for Studying the Tradeoff between Usability and Security. International Conference on Availability, Reliability and Security. 2009: 882-889.
  • 84 Soffer P, Ghattas J, Peleg M. A Goal-Based Approach for Learning in Business Processes. In Salinesi C, Souveyet C, Ralyte J. editors Intentional Perspectives on Information Systems Engineering. Springer: 2010: 239-256.
  • 85 Peleg M, Tu SW, Bury J, Ciccarese P, Fox J, Greenes RA. et al Comparing Computer-Interpretable Guideline Models: A Case-Study Approach. JAMIA 2003; 10 (01) 52-68.
  • 86 Latoszek-Berendsen A, Tange H, Herik HJ van den, Hasman A. From clinical practice guidelines to computer-interpretable guidelines. A literature overview. Methods Inf Med 2010; 49 (06) 550-570.
  • 87 Isern D, Moreno A. Computer-based execution of clinical guidelines: a review. Int J Med Inform 2008; 77 (12) 787-808.
  • 88 Peleg M, Keren S, Denekamp Y. Mapping Computerized Clinical Guidelines to Electronic Medical Records: Knowledge-Data Ontological Mapper (KDOM). J Biomed Inform 2008; 41 (01) 180-201.
  • 89 Fox J, Rahmanzadeh A. Disseminating medical knowledge: the PROforma approach. Artificial Intelligence in Medicine 1998; 14: 157-181.
  • 90 Shahar Y. The Elicitation, Representation, Application, and Automated Discovery of Time-Oriented Declarative Clinical Knowledge. In Lenz R, Miksch S, Peleg M, Riano D, Recihert M, ten Teije A. editors Lecture Notes in Artificial Intelligence Vol. 7738, Process Support and Knowledge Representation in Health Care: BPM 2012 Joint Workshop ProHealth 2012/KR4HC 2012. Springer: 2013.
  • 91 Bates DW, Kuperman GJ, Wang S, Gandhi T, Kittler A, Volk L, Spurr C, Khorasani R, Tanasijevic M, Middleton B. Ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality. JAMIA 2003; 10 (06) 523-530.
  • 92 Renkert S, Nutbeam D. Opportunities to improve maternal health literacy through antenatal education: an exploratory study. Health Promot Int 2001; 16 (04) 381-388.
  • 93 Bright TJ, Wong A, Dhurjati R, Bristow E, Bastian L, Coeytaux RR, Samsa G, Hasselblad V, Williams JW, Musty MD, Wing L, Kendrick AS, Sanders GD, Lobach D. Effect of clinical decision-support systems: a systematic review. Ann Intern Med 2012; 157 (01) 29-43.
  • 94 Jaspers MW, Smeulers M, Vermeulen H, Peute LW. Effects of clinical decision-support systems on practitioner performance and patient outcomes: a synthesis of high-quality systematic review findings. JAMIA 2011; 18 (03) 327-334.
  • 95 Holden RJ. Physicians’ beliefs about using EMR and CPOE: in pursuit of a contextualized understanding of health IT use behavior. Int J Med Inform 2010; 79 (02) 71-80.
  • 96 Khajouei R, Jaspers MW. The impact of CPOE medication systems’ design aspects on usability, workflow and medication orders: a systematic review. Methods Inf Med 2010; 49 (01) 3-19.
  • 97 Kinoshita G. et al Data analysis of the finished prescriptions; development and evaluation of the re-inspection system. Jpn J Med Inform 2007; 27 Suppl 271-273.