A machine learning-based clinical decision support system to identify prescriptions with a high risk of medication error.

Jennifer Corny; Asok Rajkumar; Olivier Martin; Xavier Dode; Jean-Patrick Lajonchère; Olivier Billuart; Yvonnick Bézie; Anne Buronfosse

Study

Emerging Classic

A machine learning-based clinical decision support system to identify prescriptions with a high risk of medication error.

October 21, 2020

Corny J, Rajkumar A, Martin O, et al. J Am Med Inform Assoc. 2020;27(11):1695–1704.

View more articles from the same authors.

Machine learning can improve the accuracy of clinical decision support (CDS) tools. This single-site study used data from the electronic health record (EHR) and clinical pharmacist review to test the accuracy of a hybrid CDS system to identify prescriptions with high risk of medication error. The machine-learning based approach was more accurate than existing techniques such as the traditional CDS system and can improve the reliability of prescription checks in an inpatient setting.

PubMed citation

Free full text

Related Resources From the Same Author(s)

The tradeoffs between safety and alert fatigue: data from a national evaluation of hospital medication-related clinical decision support.

July 29, 2020

High-priority drug-drug interaction clinical decision support overrides in a newly implemented commercial computerized provider order-entry system: override appropriateness and adverse drug events.

May 20, 2020

Patient safety and quality improvement: ethical principles for a regulatory approach to bias in healthcare machine learning.

July 22, 2020

How effective are electronic medication systems in reducing medication error rates and associated harm among hospital inpatients? A systematic review and meta-analysis.

December 2, 2020

Inviting patients to identify diagnostic concerns through structured evaluation of their online visit notes.

April 13, 2022

The potential for leveraging machine learning to filter medication alerts.

May 4, 2022

Risk factors associated with medication ordering errors.

December 16, 2020

Can decision support combat incompleteness and bias in routine primary care data?

April 7, 2021

Associations of physicians’ prescribing experience, work hours, and workload with prescription errors.

November 18, 2020

Improving patient safety and efficiency of medication reconciliation through the development and adoption of a computer-assisted tool with automated electronic integration of population-based community drug data: the RightRx project.

January 10, 2018

Enabling a learning healthcare system with automated computer protocols that produce replicable and personalized clinician actions.

August 4, 2021

Effectiveness of a ‘do not interrupt’ vest intervention to reduce medication errors during medication administration: a multicenter cluster randomized controlled trial.

October 13, 2021

Variation in electronic test results management and its implications for patient safety: a multisite investigation.

August 19, 2020

Renal medication-related clinical decision support (CDS) alerts and overrides in the inpatient setting following implementation of a commercial electronic health record: implications for designing more effective alerts.

February 17, 2021

Indication alerts to improve problem list documentation.

January 26, 2022

"Are we there yet?" Ten persistent hazards and inefficiencies with the use of medication administration technology from the perspective of practicing nurses.

March 22, 2023

Repurposing clinical decision support system data to measure dosing errors and clinician-level quality of care.

November 11, 2020

Safe use of the EHR by medical scribes: a qualitative study.

November 18, 2020

Partnering with patients and families living with chronic conditions to coproduce diagnostic safety through OurDX: a previsit online engagement tool.

February 15, 2023

Examining medication ordering errors using AHRQ Network of Patient Safety Databases.

February 22, 2023

Journal Article

Study

Clinician collaboration to improve clinical decision support: the Clickbusters initiative.

November 16, 2022

Electronic health record-based prediction models for in-hospital adverse drug event diagnosis or prognosis: a systematic review.

March 29, 2023

Maybe they had a bad day: how LGBTQ and BIPOC patients react to bias in healthcare and struggle to speak out.

September 14, 2022

CancelRx: a health IT tool to reduce medication discrepancies in the outpatient setting.

September 1, 2021

Use of an electronic clinical decision support system in primary care to assess inappropriate polypharmacy in young seniors with multimorbidity: observational, descriptive, cross-sectional study

April 8, 2020

Clinical data sharing improves quality measurement and patient safety.

March 24, 2021

Using automated methods to detect safety problems with health information technology: a scoping review.

February 8, 2023

Detectability of medication errors with a STOPP/START-based medication review in older people prior to a potentially preventable drug-related hospital admission.

December 21, 2022

Association of clinician diagnostic performance with machine learning–based decision support systems: a systematic review.

April 14, 2021

Bias at warp speed: how AI may contribute to the disparities gap in the time of COVID-19.

September 9, 2020

Preliminary study of patient safety and quality use cases for ICD-11 MMS.

September 15, 2021

It's like sending a message in a bottle: a qualitative study of the consequences of one-way communication technologies in hospitals.

October 13, 2021

Alert burden in pediatric hospitals: a cross-sectional analysis of six academic pediatric health systems using novel metrics.

November 3, 2021

Association between limiting the number of open records in a tele-critical care setting and retract-reorder errors.

July 21, 2021

Finding the right balance: an evidence-informed guidance document to support the re-opening of Canadian nursing homes to family caregivers and visitors during the coronavirus disease 2019 pandemic.

October 28, 2020

Impact of clinical decision support therapeutic interchanges on hospital discharge medication omissions and duplications.

October 20, 2021

Safety risks and workflow implications associated with nursing-related free-text communication orders.

March 15, 2023

Accuracy of emergency department clinical findings for diagnosis of coronavirus disease 2019.

July 29, 2020

Impact of digitally acquired peer diagnostic input on diagnostic confidence in outpatient cases: a pragmatic randomized trial.

December 2, 2020

Validation of an electronic trigger to measure missed diagnosis of stroke in emergency departments.

August 25, 2021

Use of an audit with feedback implementation strategy to promote medication error reporting by nurses.

November 25, 2020

Discontinuation of outpatient medications: implications for electronic messaging to pharmacies using CancelRx.

December 7, 2022

Recommendations for the safe, effective use of adaptive CDS in the US healthcare system: an AMIA position paper.

April 21, 2021

An objective framework for evaluating unrecognized bias in medical AI models predicting COVID-19 outcomes.

June 1, 2022

Overall performance of a drug-drug interaction clinical decision support system: quantitative evaluation and end-user survey.

April 13, 2022

Effect of a multifaceted clinical pharmacist intervention on medication safety after hospitalization in persons prescribed high-risk medications: a randomized clinical trial.

March 17, 2021

A program to provide clinicians with feedback on their diagnostic performance in a learning health system.

October 28, 2020

Organizational characteristics and perceptions of clinical event notification services in healthcare settings: a study of health information exchange.

December 23, 2020

Nurse workarounds in the electronic health record: an integrative review.

August 12, 2020

Applying requisite imagination to safeguard electronic health record transitions.

May 18, 2022

Trust and medical AI: the challenges we face and the expertise needed to overcome them.

April 21, 2021

Application of human factors to improve usability of clinical decision support for diagnostic decision-making: a scenario-based simulation study.

January 8, 2020

Clinical decision support improves the appropriateness of laboratory test ordering in primary care without increasing diagnostic error: the ELMO cluster randomized trial.

December 2, 2020

Use of an electronic decision support tool to reduce polypharmacy in elderly people with chronic diseases: cluster randomised controlled trial.

July 29, 2020

A case of transfusion error in a trauma patient with subsequent root cause analysis leading to institutional change.

June 15, 2016

Usability of a human factors-based clinical decision support in the emergency department: lessons learned for design and implementation.

May 11, 2022

Rate of sepsis hospitalizations after misdiagnosis in adult emergency department patients: a look-forward analysis with administrative claims data using Symptom-Disease Pair Analysis of Diagnostic Error methodology in an integrated health system.

May 12, 2021

Alternatives to opioid education and a prescription drug monitoring program cumulatively decreased outpatient opioid prescriptions.

December 16, 2020

Impact of an electronic health record alert on inappropriate prescribing of high-risk medications to patients with concurrent "do not give" orders.

August 3, 2022

The Diagnostic Error Index: a quality improvement initiative to identify and measure diagnostic errors.

February 10, 2021

Team-based approach to improving medication reconciliation rates in family medicine residency clinics.

October 7, 2020

Toward safer health care: a review strategy of FDA medical device adverse event database to identify and categorize health information technology related events.

November 28, 2018

Harnessing event report data to identify diagnostic error during the COVID-19 pandemic.

December 15, 2021

Implementation of the I-PASS handoff program in diverse clinical environments: a multicenter prospective effectiveness implementation study.

November 16, 2022

Patient errors in use of injectable antidiabetic medications: a need for improved clinic-based education.

November 4, 2020

COVID-19 pandemic preparation: using simulation for systems-based learning to prepare the largest healthcare workforce and system in Canada.

September 30, 2020

Safety climate associated with adverse events in nursing homes: a national VA study.

August 26, 2020

Expanding frontiers of risk management: care safety in nursing home during COVID-19 pandemic.

September 30, 2020

Patient engagement in the inpatient setting: a systematic review.

December 18, 2013

The MedSafer study-electronic decision support for deprescribing in hospitalized older adults: a cluster randomized clinical trial.

February 2, 2022

Safe opioid prescribing: a prognostic machine learning approach to predicting 30-day risk after an opioid dispensation in Alberta, Canada.

June 16, 2021

A machine learning approach to reclassifying miscellaneous patient safety event reports.

July 29, 2020

Computerized physician order entry with clinical decision support in long-term care facilities: costs and benefits to stakeholders.

November 7, 2007

A randomized clinical trial to compare the use of safety net enclosures with standard restraints in agitated hospitalized patients.

January 9, 2008

Using medication containers during pharmacist transitional care visits and impact on medication discrepancies identified and hospital readmission risk.

November 11, 2020

eSIMPLER: a dynamic, electronic health record-integrated checklist for clinical decision support during PICU daily rounds.

June 16, 2021

The association of nursing home characteristics and quality with adverse events after a hospitalization.

April 28, 2021

Overriding drug-drug interaction alerts in clinical decision support systems: a scoping review.

September 7, 2022

Omissions of care in nursing homes: a uniform definition for research and quality improvement.

November 18, 2020

Implementation and sustainability of a medication reconciliation toolkit: a mixed methods evaluation.

August 5, 2020

Learning from incident reporting? Analysis of incidents resulting in patient injuries in a web-based system in Swedish health care.

December 9, 2020

Clinical decision support for early recognition of sepsis.

April 20, 2016

Does increased schedule flexibility lead to change? A national survey of program directors on 2017 work hours requirements.

September 23, 2020

Cost of adverse drug events related to potentially inappropriate medication use: a systematic review.

June 15, 2022

Establishing a multidisciplinary taskforce to improve anticoagulation safety at a large health system.

December 12, 2021

Patient misidentification events in the Veterans Health Administration: a comprehensive review in the context of high-reliability health care.

October 21, 2020

March 11, 2020

The work of nurses to provide good and safe services to children receiving hospital-at-home: a qualitative interview study from the perspectives of hospital nurses and physicians.

October 20, 2021

Video-based communication assessment of physician error disclosure skills by crowdsourced laypeople and patient advocates who experienced medical harm: reliability assessment with generalizability theory.

May 18, 2022

Implementing the clinical occurrence reporting and learning system: a double-loop learning incident reporting system in long-term care.

March 24, 2021

Learning from safety incidents in high reliability organizations: a systematic review of learning tools that could be adapted and used in healthcare.

March 31, 2021

Absence or presence: silent discourse in the operating room and impact on surgical team action.

November 11, 2020

Seven features of safety in maternity units: a framework based on multisite ethnography and stakeholder consultation.

October 21, 2020

Diagnostic error experiences of patients and families with limited English-language health literacy or disadvantaged socioeconomic position in a cross-sectional US population-based survey.

February 16, 2022

Managing teamwork in the face of pandemic: evidence-based tips.

June 24, 2020

Evaluation of clinical practice guidelines on fall prevention and management for older adults: a systematic review.

January 12, 2022

Incidence, duration and risk factors associated with delayed and missed diagnostic opportunities related to tuberculosis: a population-based longitudinal study.

March 24, 2021

The impact of an electronic alert to reduce the risk of co-prescription of low molecular weight heparins and direct oral anticoagulants.

July 6, 2022

Why do hospital prescribers continue antibiotics when it is safe to stop? Results of a choice experiment survey.

September 2, 2020

Education initiatives in cognitive debiasing to improve diagnostic accuracy in student providers: a scoping review.

November 11, 2020

Related Resources

WebM&M Cases

Verbal Orders and Medication Overrides: A Dangerous Combination

April 24, 2024

Drug-drug interactions and actual harm to hospitalized patients: a multicentre study examining the prevalence pre- and post-electronic medication system implementation.

April 10, 2024

The effect of computerised decision support alerts tailored to intensive care on the administration of high-risk drug combinations, and their monitoring: a cluster randomised stepped-wedge trial.

February 14, 2024

Post-implementation optimization of medication alerts in hospital computerized provider order entry systems: a scoping review.

December 6, 2023

Inpatient EHR user experience and hospital EHR safety performance.

October 4, 2023

The impact of transition to a digital hospital on medication errors (TIME study).

August 16, 2023

Impact of a computerized physician order entry system on medication safety in pediatrics-The AVOID study.

June 7, 2023

Changes in medication safety indicators in England throughout the covid-19 pandemic using OpenSAFELY: population based, retrospective cohort study of 57 million patients using federated analytics.

June 7, 2023

Patient Safety Innovations

Remote Response Team and Customized Alert Settings Help Improve Management of Sepsis

May 31, 2023

Using sociotechnical theory to understand medication safety work in primary care and prescribers' use of clinical decision support: a qualitative study.

May 24, 2023

Interview

In Conversation with... Susan McGrath, PhD and George Blike, MD about Surveillance Monitoring

April 26, 2023

Perspective

Surveillance Monitoring to Improve Patient Safety in Acute Hospital Care Units

April 26, 2023

Indication documentation and indication-based prescribing within electronic prescribing systems: a systematic review and narrative synthesis.

April 5, 2023

Perspectives on Safety

Annual Perspective

Technology as a Tool for Improving Patient Safety

March 29, 2023

WebM&M Cases

Overdose of Gabapentin and Oxycodone in a Patient with End-Stage Renal Disease: A Case for Appropriate Interruptive Drug-Disease Alerts.

February 1, 2023

Improving administration and documentation of enteral nutrition support therapy in a Veteran Affairs health care system: use of medication administration record and bar code scanning technology.

February 1, 2023

Scaling-up a pharmacist-led information technology intervention (PINCER) to reduce hazardous prescribing in general practices: multiple interrupted time series study.

January 11, 2023

Allergic adverse drug events after alert overrides in hospitalized patients.

September 21, 2022

Effect of different interventions to help primary care clinicians avoid unsafe opioid prescribing in opioid-naive patients with acute noncancer pain: a cluster randomized clinical trial.

September 7, 2022

Overriding drug-drug interaction alerts in clinical decision support systems: a scoping review.

September 7, 2022

Free-text computerized provider order entry orders used as workaround for communicating medication information.

August 31, 2022

Development and pilot evaluation of an electronic health record usability and safety self-assessment tool.

August 24, 2022

Algorithm that detects sepsis cut deaths by nearly 20 percent.

August 24, 2022

Impact of an electronic health record alert on inappropriate prescribing of high-risk medications to patients with concurrent "do not give" orders.

August 3, 2022

Changes to primary care delivery during the COVID-19 pandemic and perceived impact on medication safety: a survey study.

June 29, 2022

The potential for leveraging machine learning to filter medication alerts.

May 4, 2022

Overall performance of a drug-drug interaction clinical decision support system: quantitative evaluation and end-user survey.

April 13, 2022

Annual Perspective

Annual Perspective: Topics in Medication Safety

March 31, 2022

Medication safety in the emergency department: a study of serious medication errors reported by 101 hospitals from 2011 to 2020.

March 30, 2022

Antibiotic prescribing errors in patients discharged from the pediatric emergency department.

March 30, 2022

See More About The Topic

Hospitals

Information Professionals

Medicine

Ordering/Prescribing Errors

Specific to High-Risk Drugs

A machine learning-based clinical decision support system to identify prescriptions with a high risk of medication error.

Clinician collaboration to improve clinical decision support: the Clickbusters initiative.

Remote Response Team and Customized Alert Settings Help Improve Management of Sepsis

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

A machine learning-based clinical decision support system to identify prescriptions with a high risk of medication error.

Clinician collaboration to improve clinical decision support: the Clickbusters initiative.

Remote Response Team and Customized Alert Settings Help Improve Management of Sepsis

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Submit Your Innovations

Continue as a Guest

Continue Logged In

Submit Your Innovations

Continue as a Guest

Continue logged in

New Users to the PSNet site