Search results for "Information Professionals"

Admitted to the hospital after hours, a patient with a history of type A aortic dissection had his CT scan read as "no acute changes." However, the CT scan had been compared to a text report of a previous scan, rather than the images. The patient died several hours later, and autopsy revealed the dissection had progressed and ruptured.

Computerized decision support and advanced computing are being used to augment various processes in health care, such as medication ordering and diagnosis. This magazine article reports on the accuracy of these systems and the potential role of artificial intelligence in supporting diagnostic decision making.

Infobuttons, a form of clinical decision support, are small icons in the electronic health record that allow users to access online knowledge resources. This systematic review found some evidence that infobuttons may be helpful despite infrequent use. The authors advocate for further research to determine optimal design and implementation of infobuttons in electronic health records.

Insufficient training on electronic health record systems can hinder user satisfaction. This literature review assessed the evidence on training methods, such as simulation scenarios and classroom-based sessions, for electronic prescribing systems. The authors suggest that future research should examine how to educate users about challenges associated with electronic systems.

Compared to paper charts, electronic health records offer safety benefits for physician documentation including better availability and legibility. However, electronic documentation introduces new concerns, such as copy-and-paste practices (which can perpetuate errors) and lack of diagnostic reasoning in electronic notes. This study compared physical exam documentation in initial physician progress notes before and after implementation of an electronic health record. Investigators found more inaccuracies in electronic notes, but more errors of omission in paper charts. Trainee physicians' documentation had fewer errors in both paper and electronic formats. The authors recommend that hospitals discourage copied notes and encourage accurate documentation at the time of the patient encounter. The importance of the physical examination itself was discussed in a PSNet interview with Dr. Abraham Verghese.

Presenting to his new primary physician's office for his first visit, a man was checked in under the record of an existing patient with the exact same name and age. The mistake wasn't noticed until the established patient received the new patient's test results by email.

According to this retrospective chart review study, clinically significant prescription errors continued to occur at an alarming rate in a pediatric emergency department, despite the introduction of computerized provider order entry. Emergency medicine residents made more prescribing errors than pediatric residents.

While computerized physician order entry is expected to significantly reduce adverse drug events, systems must be implemented thoughtfully to avoid facilitating certain types of errors. A forcing function that mandated correct patient identification resulted in a moderate decrease in wrong-patient prescribing errors within a computerized provider order entry system.

Misdiagnosis and errors linked to electronic health records (EHRs) are common concerns in patient safety. This commentary examines these elements in the context of the first Ebola case in the United States to reveal weaknesses in emergency department care, disaster management, and diagnostic processes. The case analysis highlights challenges associated with forming diagnoses and the usability of EHRs as decision support tools.

Highlighting how heuristics can both increase and reduce risk of diagnostic error, this commentary applies a set of recommended criteria to examine its usefulness in guiding research and augmenting understanding about factors that affect clinical reasoning and support accurate decision making.

This commentary spotlights the importance of learning about cognitive science to understand and improve diagnostic reasoning in order to prevent errors. Underscoring limits of the Hippocratic Oath, the authors describe the ethical responsibility of individuals and organizations to augment clinical decision-making, judgment, and critical thinking skills as an integral component of professionalism.

This webinar series featured three sessions that covered root cause analysis, patient engagement, and health information technology as strategies to reduce diagnostic errors. Speakers include Dr. Gordon Schiff, Dr. Tejal Gandhi and Dr. Mark Graber. Session materials and additional resources are also on the site.

The handwritten prescription pad is vanishing from clinical practice, replaced by the proliferation of e-prescribing. There are many advantages to this technology, but prescribing errors still occur at alarming rates. This study explored the approaches community pharmacists and technicians utilize to detect and manage e-prescription errors.

This review describes methods to address system and cognitive weaknesses in the diagnostic process.

This review outlines 10 categories of tools, algorithms, and research methods used to examine the role of health information technology in reducing diagnostic errors.

This commentary describes how question answering systems can augment evidence-based decision making in clinical care.

This newspaper article reports on the complexity of the diagnostic process and details how clinical decision support systems combined with physicians' logic and knowledge base can prevent diagnostic errors.

Although health information technology (IT) holds great promise for improving patient safety, many of the purported benefits have not yet been realized, and an ever-lengthening list of implementation problems and unintended consequences have been documented. This Institute of Medicine report states that "the current state of safety and health IT is not acceptable" and discusses various safety issues associated with health IT. The report contains a series of recommendations for evaluating and monitoring the safety of health IT, ranging from greater attention to interoperability and human factors engineering in the health IT design process to revisiting the "hold harmless" clause that currently limits health IT vendor liability should systems fail. The Agency for Healthcare Research and Quality recently published an online guide to reducing safety consequences of electronic health records.

This article discusses how diagnostic decision-support systems can assist physicians in correctly diagnosing patients.

Failure to enter documentation of a DNR order causes a severely ill elderly man to be resuscitated against his wishes. Shortly thereafter, the patient's wife confirms his wishes, and within minutes, the patient dies.