Testing modes of computerized sepsis alert notification delivery systems.

Authors:
Mikhail A Dziadzko
Mikhail A Dziadzko
Mayo Clinic
Rochester | United States
Dr Andrew M Harrison, MD, PhD
Dr Andrew M Harrison, MD, PhD
Mayo Clinic
Postdoctoral researcher
Clinical Informatics
Rochester, MN | United States
Ing C Tiong
Ing C Tiong
Mayo Clinic
Rochester | United States
Brian W Pickering
Brian W Pickering
Mayo Clinic
United States
Vitaly Herasevich
Vitaly Herasevich
Mayo Clinic
United States

BMC Med Inform Decis Mak 2016 12 9;16(1):156. Epub 2016 Dec 9.

Department of Anesthesiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.

Background: The number of electronic health record (EHR)-based notifications continues to rise. One common method to deliver urgent and emergent notifications (alerts) is paging. Despite of wide presence of smartphones, the use of these devices for secure alerting remains a relatively new phenomenon.

Methods: We compared three methods of alert delivery (pagers, EHR-based notifications, and smartphones) to determine the best method of urgent alerting in the intensive care unit (ICU) setting. ICU clinicians received randomized automated sepsis alerts: pager, EHR-based notification, or a personal smartphone/tablet device. Time to notification acknowledgement, fatigue measurement, and user preferences (structured survey) were studied.

Results: Twenty three clinicians participated over the course of 3 months. A total of 48 randomized sepsis alerts were generated for 46 unique patients. Although all alerts were acknowledged, the primary outcome was confounded by technical failure of alert delivery in the smartphone/tablet arm. Median time to acknowledgment of urgent alerts was shorter by pager (102 mins) than EHR (169 mins). Secondary outcomes of fatigue measurement and user preference did not demonstrate significant differences between these notification delivery study arms.

Conclusions: Technical failure of secure smartphone/tablet alert delivery presents a barrier to testing the optimal method of urgent alert delivery in the ICU setting. Results from fatigue evaluation and user preferences for alert delivery methods were similar in all arms. Further investigation is thus necessary to understand human and technical barriers to implementation of commonplace modern technology in the hospital setting.

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http://dx.doi.org/10.1186/s12911-016-0396-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5148853PMC

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December 2016
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References

(Supplied by CrossRef)

AAMI et al.
2011
Article in J Inform Sci
RM Losee Jr et al.
J Inform Sci 1989
Article in Crit Care Med
Y Donchin et al.
Crit Care Med 1995
Article in J Biomed Inform
J Zhang et al.
J Biomed Inform 2003
Article in Risk Manag Healthc Policy
PS Gill et al.
Risk Manag Healthc Policy 2012
Article in BMC Med Inform Decis Mak
AA Marian et al.
BMC Med Inform Decis Mak 2012
Article in JAMA
DW Bates et al.
JAMA 1995
Article in J Am Med Inform Assoc
DW Bates et al.
J Am Med Inform Assoc 1999
Article in JAMA
RA Raschke et al.
JAMA 1998
Article in JAMA Intern Med
H Singh et al.
JAMA Intern Med 2013
Article in Med Care
PA Glassman et al.
Med Care 2006

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