A concise drug alerting rule set for Chinese hospitals and its application in computerized physician order entry (CPOE)

BACKGROUND: A minimized and concise drug alerting rule set can be effective in reducing alert fatigue. OBJECTIVES: This study aims to develop and evaluate a concise drug alerting rule set for Chinese hospitals. The rule set covers not only western medicine, but also Chinese patent medicine that is widely used in Chinese hospitals. SETTING: A 2600-bed general hospital in China. METHODS: In order to implement the drug rule set in clinical information settings, an information model for drug rules was designed and a rule authoring tool was developed accordingly. With this authoring tool, clinical pharmacists built a computerized rule set that contains 150 most widely used and error-prone drugs. Based on this rule set, a medication-related clinical decision support application was built in CPOE. Drug alert data between 2013/12/25 and 2015/07/01 were used to evaluate the effect of the rule set. MAIN OUTCOME MEASURE: Number of alerts, number of corrected/overridden alerts, accept/override rate. RESULTS: Totally 18,666 alerts were fired and 2803 alerts were overridden. Overall override rate is 15.0% (2803/18666) and accept rate is 85.0%. CONCLUSIONS: The rule set has been well received by physicians and can be used as a preliminary medical order screening tool to reduce pharmacists’ workload. For Chinese hospitals, this rule set can serve as a starter kit for building their own pharmaceutical systems or as a reference to tier commercial rule set.