Odds of patient complications increase by 29% when physicians don't follow EHR alerts, study suggests

Providers who adhere to clinical decision support alerts embedded in EHRs report better clinical outcomes for their patients than those who don't, according to a study published in the American Journal of Managed Care.

Researchers from Los Angeles-based Cedars-Sinai Medical Center and consultancy Optum Advisory Services reviewed data from more than 26,000 inpatient visits during the study, dividing patients into two groups: one in which the provider adhered to all CDS alerts, and one in which the provider did not adhere to the recommendations.

The CDS alerts were from Choosing Wisely, a program developed by the American Board of Internal Medicine Foundation. Choosing Wisely alerts providers when care instructions deviate from existing industry guidelines, such as if a provider orders a CT scan that may not be necessary or if a provider prescribes a sedative for a patient at risk for falls.

The odds of experiencing a complication increased by 29 percent for patients whose physicians did not follow CDS alerts, and the odds of a hospital readmission increased by 14 percent. These patients also experienced a 6.2 percent increase in their length of stay and a 7.3 percent increase in costs.

"Sometimes doctors order tests that they think are in the patient's best interest, when research doesn't show that to be the case," Harry C. Sax, MD, executive vice chair of surgery at Cedars-Sinai and a senior author on the study, said in a news release. "This work is about giving the right care that patients truly need."

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