Informatics-Review > Vol. 6 No. 9 - May 1 2003 -- Current Reviews in Clinical Informatics 








Prioritizing Strategies for Preventing
Medication Errors and Adverse Drug Events in Pediatric Inpatients

Of 10, 778 medication orders reviewed, 616 contained errors. Of these,
120 (19.5%) were classified as potentially harmful, including 115
potential adverse drug events (18.7%) and 5 preventable adverse drug
events (0.8%). Most errors occurred at the ordering stage (74%) and
involved errors in dosing (28%), route (18%), or frequency (9%). Three
interventions might have prevented most potentially harmful errors: 1)
computerized physician order entry with clinical decision support
systems (76%); 2) ward-based clinical pharmacists (81%); and 3) improved
communication among physicians, nurses, and pharmacists (86%).



Cultural & Political Challenges in
Computerized Clinician Order Entry: A guide to smooth implementation and
maintenance

One of the most exciting tools in our Clinical Decision Support (CDS)
armamentarium is Computerized Physician Order Entry (CPOE). Studies
consistently confirm a 60-70% reduction of Adverse Drug Events (ADEs) in
hospitals using CPOE. The number of steps involved in the ordering and
administration of medications (and consequent opportunities for human
error) in hospital settings is markedly reduced by CPOE. Patients are
afforded added protection from inadvertent harm, and physicians benefit
from a reduction in their own exposure to liability for errors as a
result of CPOE. Yet the processes of persuasion involved in practitioner
conversion to CPOE remains one of the most daunting challenges for
hospitals and implementers of CDS healthcare information systems with
non-employed (voluntary) medical staffs. Short of legislative or
enterprise mandate, the majority of healthcare organizations (HCOs)
encounter remarkably similar cultural and political obstacles that
challenge even the most innovative champions of CPOE.



American Oncologists’ Views of Internet Use
by Cancer Patients: A Mail Survey of American Society of Clinical
Oncology Members

Response rate to this mail survey was 46.2%. Oncologists’ median
estimate of the proportion of their patients using the Internet to
obtain cancer information was 30%. Subjects responded that, on average,
10 minutes were added to each patient encounter in which Internet
information was discussed. Responding
oncologists reported that use of the Internet had the ability to
simultaneously make patients more hopeful, confused, anxious, and
knowledgeable. Forty-four percent of responding oncologists
reported that they sometimes or rarely had difficulty discussing
Internet information, and only 9% of subjects reported that they
sometimes or always felt threatened when patients brought Internet
information to discuss. In narrative responses, oncologists reported
both positive and negative effects of Internet use by patients.



Developing a National Action Agenda for NHII

Expert panels from organizations such as the National Committee on
Vital and Health Statistics, the President’s Information Technology
Advisory Committee, and the Institute of Medicine, have emphasized the
importance of a national health information infrastructure (NHII), which
is essential to improving patient safety and quality, rapidly detecting
bioterrorism and other health threats, and enhancing the efficiency of
the health care system. DHHS is taking a leadership role to promote
public-private collaboration to facilitate NHII progress. This
conference will bring together all the health information technology
stakeholders to develop a consensus for national action.



Evaluation of an Internet-based smoking
cessation program: Lessons learned from a pilot study

The potential contribution of the Internet to smoking cessation seems
huge, given that a majority of Americans now have both computers and
telephones. Despite the proliferation of Web sites offering smoking
cessation support, there is little empirical evidence regarding the
efficacy of Internet-delivered cessation programs. The cessation rate
(abstinence for the previous 7 days) at 3 months was 18%, with
nonrespondents (n=161) considered smokers. Methodological and procedural
issues posed in conducting research on the Internet are discussed.



Technology and Psychiatry 2003: Changing
our Minds

The annual meeting of The American Association for Technology in
Psychiatry will be held May 17, 2003 at the Hotel Nikko, San Francisco.



LA County's main hospital has computer
breakdown, delays ensue

The computer system apparently became overloaded once it was activated
and a technical glitch kept it from communicating with the machine that
processed tests. Lab technicians also struggled to solve problems with
the system when it froze. Urgent lab tests were delayed up to three
hours and regular lab tests took even longer to process.



Text generation in clinical medicine

This article aims at an analysis of ways of producing documents (such
as findings or referral letters) in clinical medicine. Special emphasis
is given to the question of whether the field of "Natural Language
Generation" (NLG) can provide new approaches to ameliorate the current
situation.



Committee on Patient Safety Data Standards
-- 5th Meeting

The purpose of this 24-month IOM project is to produce a detailed plan
to facilitate the development of data standards applicable to the
collection, coding and classification of patient safety information. The
plan will apply to both adverse event data and errors data. (Links to
several presentations from the meeting.)



The
Emerging Technologies & Healthcare Innovations Congress
provides healthcare industry executives with an in-depth conference
convening clinicians, healthcare executives, technology thought leaders
and vendors to address the impact and promise of technology and
innovation on the future of healthcare.



The Effects of Promoting Patient Access to
Medical Records: A Review

This article analyzes the potential benefits and drawbacks of
facilitating patient access to the medical record by reviewing
previously published research. Overall, studies suggest the potential
for modest benefits (for instance, in enhancing doctor-patient
communication). Risks (for instance, increasing patient worry or
confusion) appear to be minimal in medical patients.

 

Other issues from
Volume 6 -- 2001


  
    

      
      
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 Informatics-Review  >  Vol. 6  No. 9  - May 1  2003 --  Current    Reviews in Clinical
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4/28/03 dfs