A concise drug alerting rule set for Chinese hospitals and its application in computerized physician order entry (CPOE)

BackgroundA minimized and concise drug alerting rule set can be effective in reducing alert fatigue.ObjectivesThis study aims to develop and evaluate a concise drug alerting rule set for Chinese hospitals. The rule set covers not only western medicine, but also Chinese patent medicine that is widely used in Chinese hospitals.SettingA 2600-bed general hospital in China.MethodsIn order to implement the drug rule set in clinical information settings, an information model for drug rules was designed and a rule authoring tool was developed accordingly. With this authoring tool, clinical pharmacists built a computerized rule set that contains 150 most widely used and error-prone drugs. Based on this rule set, a medication-related clinical decision support application was built in CPOE. Drug alert data between 2013/12/25 and 2015/07/01 were used to evaluate the effect of the rule set.Main outcome measureNumber of alerts, number of corrected/overridden alerts, accept/override rate.ResultsTotally 18,666 alerts were fired and 2803 alerts were overridden. Overall override rate is 15.0% (2803/18666) and accept rate is 85.0%.ConclusionsThe rule set has been well received by physicians and can be used as a preliminary medical order screening tool to reduce pharmacists’ workload. For Chinese hospitals, this rule set can serve as a starter kit for building their own pharmaceutical systems or as a reference to tier commercial rule set.

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