Wipfli Rolf, Betrancourt Mireille, Guardia Alberto, Lovis Christian
Division of Medical Information Sciences, University of Geneva and University Hospitals of Geneva, Switzerland.
Stud Health Technol Inform. 2011;169:940-4.
Medical alerts in CPOE are overridden in most cases. The need for alerting systems that are better adapted to physicians' needs and work processes is recognized. Our study aims to shed some light on how medical alerts are used and how they are integrated in the work process. Work analysis and interviews resulted in a hierarchical task analysis of prescription during ward rounds at the University Hospitals of Geneva. The results indicate that non-modal medical alerts are appreciated as an "insurance" for drugs that are out of the routine set. In the case of drugs that are often prescribed, alerts are ignored as physicians feel comfortable prescribing them. Non-interrupting alerts do not cognitively overcharge physicians, but the question is how to display the numerous alerts so that they are easily accessible when needed. Further, inexperienced physicians lack a mental representation of what evaluations the system is doing with the prescriptions and when alerts are triggered. This may lead to lack of trust or overconfidence, both of them potentially harmful.
在大多数情况下，计算机化医嘱录入系统（CPOE）中的医疗警报会被忽略。人们认识到需要有更适合医生需求和工作流程的警报系统。我们的研究旨在阐明医疗警报是如何被使用的，以及它们是如何融入工作流程的。通过工作分析和访谈，对日内瓦大学医院查房期间的处方进行了层次任务分析。结果表明，非模态医疗警报被视为常规用药之外药物的一种“保障”。对于经常开具的药物，由于医生对开具这些药物感到放心，警报会被忽略。不打断工作的警报不会给医生造成认知负担，但问题在于如何显示大量警报，以便在需要时能够轻松获取。此外，经验不足的医生对系统针对处方进行的评估以及警报触发时机缺乏心理认知。这可能导致缺乏信任或过度自信，而这两者都可能有害。
