Computerized Medication Alerts and Prescriber Mental Models: Observing Routine Patient Care

Alissa L. Russ, Jason J. Saleem, M. Sue McManus, Alan J. Zillich, Bradley N. Doebbeling

Research output: Chapter in Book/Report/Conference proceedingConference contribution

7 Scopus citations

Abstract

Computerized medication alerts (e.g., drug-drug interactions, drug-allergy interactions), which are intended to protect patient safety, need to match the mental models of medication prescribers in order to aid medication ordering. To maximally protect patient safety, the programmer mental model, system image, and prescriber mental model should work seamlessly together to fully support prescriber decision-making. In this study, we examined prescribing processes in the context of routine patient care to understand how the design of medication alerts can be enhanced for prescribers. We shadowed prescribers, including physicians, pharmacists, and nurse practitioners, across five outpatient primary care clinics at a large Veterans Affairs Medical Center (VAMC). In addition, prescribers were opportunistically interviewed as they ordered mediations via a computerized order entry system and resolved any subsequent medication alerts. This investigation is one of the few to examine medication alerts by directly observing prescribers during patient care. Altogether, 191 medication alerts occurred across 63.5 total hrs of observation, 19 prescribers, and 86 patients during routine patient care tasks. Results reveal problematic system images and mismatches between programmer and prescriber mental models. Findings can help inform medication alert redesigns, which may promote safer, more effective prescribing practices.

Original languageEnglish (US)
Title of host publication53rd Human Factors and Ergonomics Society Annual Meeting 2009, HFES 2009
PublisherHuman Factors an Ergonomics Society Inc.
Pages655-659
Number of pages5
ISBN (Print)9781615676231
DOIs
StatePublished - 2009
Externally publishedYes
Event53rd Human Factors and Ergonomics Society Annual Meeting 2009, HFES 2009 - San Antonio, TX, United States
Duration: Oct 19 2009Oct 23 2009

Publication series

NameProceedings of the Human Factors and Ergonomics Society
Volume1
ISSN (Print)1071-1813

Other

Other53rd Human Factors and Ergonomics Society Annual Meeting 2009, HFES 2009
CountryUnited States
CitySan Antonio, TX
Period10/19/0910/23/09

ASJC Scopus subject areas

  • Human Factors and Ergonomics

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