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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Case Report

A Clinical Case of Electronic Health Record Drug Alert Fatigue: Consequences for Patient Outcome

C. William Carspecken, Paul J. Sharek, Christopher Longhurst and Natalie M. Pageler
Pediatrics June 2013, 131 (6) e1970-e1973; DOI: https://doi.org/10.1542/peds.2012-3252
C. William Carspecken
aDepartment of Biomedical Informatics, Stanford University, Stanford, California;
bHarvard Medical School, Boston, Massachusetts;
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Paul J. Sharek
cCenter for Quality and Clinical Effectiveness, Lucile Packard Children’s Hospital, Palo Alto, California; and
Divisions of dGeneral Pediatrics,
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Christopher Longhurst
eSystems Medicine, and
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Natalie M. Pageler
fCritical Care Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
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Abstract

Despite advances in electronic medication order entry systems, it has been well established that clinicians override many drug allergy alerts generated by the electronic health record. The direct clinical consequences of overalerting clinicians in a pediatric setting have not been well demonstrated in the literature. We observed a patient in the PICU who experienced complications as a result of an extended series of non–evidence-based alerts in the electronic health record. Subsequently, evidence-based allergy alerting changes were made to the hospital’s system. Incorporating clinical evidence in electronic drug allergy alerting systems remains challenging, especially in pediatric settings.

  • electronic health record
  • drug allergy
  • alert fatigue
  • pediatrics
  • clinical decision support systems
  • override
  • quality improvement
  • adverse drug event
  • Abbreviations:
    ADE —
    adverse drug event
    CDSS —
    clinical decision support systems
    EHR —
    electronic health record
    • Accepted January 30, 2013.
    • Copyright © 2013 by the American Academy of Pediatrics

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    Pediatrics
    Vol. 131, Issue 6
    1 Jun 2013
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    A Clinical Case of Electronic Health Record Drug Alert Fatigue: Consequences for Patient Outcome
    C. William Carspecken, Paul J. Sharek, Christopher Longhurst, Natalie M. Pageler
    Pediatrics Jun 2013, 131 (6) e1970-e1973; DOI: 10.1542/peds.2012-3252

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    A Clinical Case of Electronic Health Record Drug Alert Fatigue: Consequences for Patient Outcome
    C. William Carspecken, Paul J. Sharek, Christopher Longhurst, Natalie M. Pageler
    Pediatrics Jun 2013, 131 (6) e1970-e1973; DOI: 10.1542/peds.2012-3252
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    Subjects

    • Dermatology
      • Dermatology
    • Health Information Technology
      • Health Information Technology
      • Electronic Health Records
    • Administration/Practice Management
      • Quality Improvement
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    Keywords

    • electronic health record
    • drug allergy
    • alert fatigue
    • pediatrics
    • clinical decision support systems
    • override
    • quality improvement
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