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Discussion

Best Practice Advisory

So I've been tasked with the research of the advantages and disadvantages of Best Practice Advisories/Alerts (BPA) within an EMR.

For example, if a patient was screened by a nurse that this patient has not had a pneumonia vaccine, a popup (best practice alert) will appear to the user indicating that his patient is eligible for a pneumonia vaccine, do you want to order? Then it will take you to the order. This is just one of the 200+ BPA examples that my hospital uses.

I've done some simple Google searches to look up this kind of thing and I'm not finding a whole lot on the subject. So I'm seeking your assistance in finding resources that identify the good and the bad things about these alerts. Also maybe some first hand experience? An example of one issue is "Alert Fatigue" in which the user sees so many alerts that they just begin to ignore it.

In addition, what other clinical support decisions do you use in your EMR and in what situations? Utilizing the EHR, are there any other decision support technologies that help clinicians make the right choices?

If you find any good articles (preferably research) related to this topic please post it here so I can take a look.

Thank you for your help!

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    Hello,

    You are probably here for research, not sure if I could tell you in a few words what you're looking for but as an EPIC end-user, BPA's work well when they aren't too many. At first, my organization started out with just a few and now we have so many that many nurses just click them all without even reading them first. Many of the BPA's that are generated when we do an admission are usually recommended for us to contact the physician to have them order so and so. Many nurse's and myself rarely get a chance to contact they physicians or sometimes when we do they say they will or never actually get it done. So, these alert's which are usually highlighted just sit there even past discharge. I'm not sure what they physicians screen look like or even if they have BPA's but they could care less.

    The BPA's that are targeting for nursing are usually the ones that are done, for example, care planning and teaching. Most often, these BPA's are generated based on an assessment or diagnosis. Most nurse's have to do this anyway so it often gets done and the BPA alert goes away.

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