Department of Informatics, University of California, Irvine, Irvine, California, USA.
Department of Anesthesiology and Perioperative Care, School of Medicine, University of California, Irvine, Irvine, California, USA.
J Am Med Inform Assoc. 2020 Apr 1;27(4):613-620. doi: 10.1093/jamia/ocz213.
The United States faces an opioid crisis. Integrating prescription drug monitoring programs into electronic health records offers promise to improve opioid prescribing practices. This study aimed to evaluate 2 different user interface designs for prescription drug monitoring program and electronic health record integration.
Twenty-four resident physicians participated in a randomized controlled experiment using 4 simulated patient cases. In the conventional condition, prescription opioid histories were presented in tabular format, and computerized clinical decision support (CDS) was provided via interruptive modal dialogs (ie, pop-ups). The alternative condition featured a graphical opioid history, a cue to visit that history, and noninterruptive CDS. Two attending pain specialists judged prescription appropriateness.
Participants in the alternative condition wrote more appropriate prescriptions. When asked after the experiment, most participants stated that they preferred the alternative design to the conventional design.
How patient information and CDS are presented appears to have a significant influence on opioid prescribing behavior.
美国正面临阿片类药物危机。将处方药物监测计划整合到电子健康记录中有望改善阿片类药物的处方实践。本研究旨在评估处方药物监测计划和电子健康记录整合的 2 种不同用户界面设计。
24 名住院医师参与了一项随机对照实验，使用了 4 个模拟患者病例。在常规条件下，处方阿片类药物的历史记录以表格形式呈现，计算机化临床决策支持（CDS）通过中断式模态对话框（即弹出窗口）提供。替代条件具有图形化的阿片类药物历史记录、访问该历史记录的提示和非中断式 CDS。2 名主治疼痛专家判断处方的适当性。
参与替代条件的参与者开出了更合适的处方。在实验结束后被问到，大多数参与者表示他们更喜欢替代设计而不是常规设计。
患者信息和 CDS 的呈现方式似乎对阿片类药物的处方行为有重大影响。
