Electronic medical records: a critical evaluation of the ALERT system
Keywords:
computerized medical records systems, medical order entry systems, database management systems, clinical decisions support systemsAbstract
Background: electronic medical records (EMR) are computerized
systems with a potential beneficial effect in health care, in terms
of improving quality and minimizing error. The ALERT system is
a rapidly growing EMR in the whole world, and is the most used EMR in public hospitals in Portugal.
Methods: we reviewed current articles on information technology benefits to health care carrying out a critical evaluation of
our ongoing experience with the ALERT system.
Results: among the several functionalities proven to be beneficial on an EMR, the ALERT systems have two: recording and
conveying information as well as therapy and additional tests
prescriptions. There are several dysfunctions on these two
functionalities, as well as on other areas of the system.
Conclusions: the ALERT system is an EMR in need of improvement on three main areas: the user interface, its function on
therapy guidance and the ability to respond to the user’s demands.
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References
Bates DW, Gawande AA. Patient safety: improving safety with information technology. N Engl J Med 2003; 348: 2526-2534.
Blumenthal D, Glaser JP. Information technology comes to medicine. N Engl J med 2007; 356: 2527-2534.
James BC. Making it easy to do it right. N Engl J Med 2001; 345: 991-992.
Hartzband P, Groopman J. Off the record: avoiding the pitfalls of going electronic. N Engl J Med 2008; 358: 1656-1658.
Evans RS, Pestonik SL, Classen DC et al. A computer-assisted management program for antibiotics and other antiinfective agents. N Engl J Med 1998; 338: 232-238.
Dexter PR, Perkins S, Overhage JM, Maharry K, Kohler RB, McDonald CJ. A computerized reminder system to increase the use of preventive care for hospitalized patients. N Engl J Med 2001; 345: 965-970.
Raschke RA, Gollihare B, Wunderlich TA et al. A computer alert system to prevent injury from adverse drug events: development and evaluation in a community teaching hospital. JAMA 1998; 280: 1317-1320.
Leape LL, Bates DW, Cullen DJ et al. Systems analysis of adverse drug events. ADE Prevention Study Group. JAMA 1995; 274: 35-43.
Bates DW, Leape LL, Cullen DJ et al. Effect of computerized order entry and a team intervention on prevention of serious medication errors. JAMA 1998; 280: 1311-1316.
Bates DW. Using information technology to reduce rates of medication errors in hospitals. BMJ 2000; 320: 788-791.
Wanlass RL, Reutter SL, Kline AE. Communication among rehabilitation staff: “mild”, “moderate”, or “severe” deficits? Arch Phys Med Rehabil 1992; 73: 477-481.
Greenlaw J. Legally speaking: the deadly toll of communication failure. RN (For Managers) 1982; 45: 81-84.
Schmidt IK, Svarstad BL. Nurse-physician communication and quality of drug use in Swedish nursing homes. Soc Sci Med 2002; 54: 1767-1777.
Litvin CB. In the dark: the case for electronic health records. N Engl J Med 2007; 356: 2454-2455.
Baxt WG, Skora J. Prospective validation of artificial neural network trained to identify acute myocardial infarction. Lancet 1996; 347: 12-15.
Heden B, Ohlin H, Rittner R, Edenbrandt L. Acute myocardial infarction detected in the 12-lead ECG by artificial neural networks. Circulation 1997; 96: 1798-1802.
Bates DW, Miller EB, Cullen DJ et al. Patient risk factors for adverse drug events in hospitalizad patients. Arch Intern Med 1999; 159: 2553-2560.
Bates DW, Cohen M, Leape LL, Overhage JM, Shabot MM, Sheridan T. Reducing the frequency of errors in medicine using information technology. J Am Med Inform Assoc 2001; 8: 299-308.
Classen DC, Pestonik SL, Evans RS, Bueke JP. Computerized surveillance of adverse drug events in hospital patients. JAMA 1991; 266: 2847-2851.
Evans RS, Larsen RA, Burke JP et al. Computerized surveillance of hospitalacquired infections and antibiotic use. JAMA 1986; 256: 1007-1011.
Honigman B, Lee J, Rothschild J et al. Using computerized data to identify adverse drug events in outpatients. J Am Med Inform Assoc 2001; 8: 254-266.
Bates DW, Evans RS, Murff HJ, Stetson PD, Pizziferri L, Hripcsak G. Detecting adverse events using information technology. J Am Med Inform Assoc 2003; 10: 115-128
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