More than half of alerts created by clinical decision support software are overridden by physicians, according to a study in the Journal of the American Medical Informatics Association.
Researchers analyzed 157,483 CDS alerts from 2,004,069 medication orders, and then reviewed a subset of 600 overrides for clinical appropriateness.
Results showed 82,889 of the CDS alerts, or 52.6 percent, were overridden. The most likely alerts to be overridden include formulary substitutions (85 percent), age-based recommendations (79 percent), renal recommendations (78 percent) and patient allergies (77.4 percent).
Based on results from the override subset, 53 percent of overrides were clinically appropriate. Rates of appropriateness varied by the type of alert, from renal recommendations (12 percent) to patient allergies (92 percent).
Researchers cited alarm fatigue as a main cause of overridden alarms.
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The Case for Integrated Clinical Decision Support Software in EMRs
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