{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T02:02:18Z","timestamp":1769911338434,"version":"3.49.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,12,27]],"date-time":"2021-12-27T00:00:00Z","timestamp":1640563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R01-HS024945"],"award-info":[{"award-number":["R01-HS024945"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["T32-HS026121"],"award-info":[{"award-number":["T32-HS026121"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Problem lists represent an integral component of high-quality care. However, they are often inaccurate and incomplete. We studied the effects of alerts integrated into the inpatient and outpatient computerized provider order entry systems to assist in adding problems to the problem list when ordering medications that lacked a corresponding indication.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We analyzed medication orders from 2 healthcare systems that used an innovative indication alert. We collected data at site 1 between December 2018 and January 2020, and at site 2 between May and June 2021. We reviewed random samples of 100 charts from each site that had problems added in response to the alert. Outcomes were: (1) alert yield, the proportion of triggered alerts that led to a problem added and (2) problem accuracy, the proportion of problems placed that were accurate by chart review.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Alerts were triggered 131\u00a0134, and 6178 times at sites 1 and 2, respectively, resulting in a yield of 109\u00a0055 (83.2%) and 2874 (46.5%), P&amp;lt; .001. Orders were abandoned, for example, not completed, in 11.1% and 9.6% of orders, respectively, P&amp;lt;.001. Of the 100 sample problems, reviewers deemed 88%\u2009\u00b1\u20093% and 91%\u2009\u00b1\u20093% to be accurate, respectively, P = .65, with a mean of 90%\u2009\u00b1\u20092%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Indication alerts triggered by medication orders initiated in the absence of a justifying diagnosis were useful for populating problem lists, with yields of 83.2% and 46.5% at 2 healthcare systems. Problems were placed with a reasonable level of accuracy, with 90%\u2009\u00b1\u20092% of problems deemed accurate based on chart review.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocab285","type":"journal-article","created":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T12:57:31Z","timestamp":1639054651000},"page":"909-917","source":"Crossref","is-referenced-by-count":10,"title":["Indication alerts to improve problem list documentation"],"prefix":"10.1093","volume":"29","author":[{"given":"Anne","family":"Grauer","sequence":"first","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center, New York City, New York, USA"}]},{"given":"Jerard","family":"Kneifati-Hayek","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center, New York City, New York, USA"}]},{"given":"Brian","family":"Reuland","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center, New York City, New York, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4137-6069","authenticated-orcid":false,"given":"Jo R","family":"Applebaum","sequence":"additional","affiliation":[{"name":"Department of Quality and Patient Safety, New York-Presbyterian Hospital, New York City, New York, USA"}]},{"given":"Jason S","family":"Adelman","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center, New York City, New York, USA"},{"name":"Department of Quality and Patient Safety, New York-Presbyterian Hospital, New York City, New York, USA"}]},{"given":"Robert A","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center, New York City, New York, USA"},{"name":"Department of Quality and Patient Safety, New York-Presbyterian Hospital, New York City, New York, USA"}]},{"given":"Jeanette","family":"Lisak-Phillips","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center, New York City, New York, USA"}]},{"given":"David","family":"Liebovitz","sequence":"additional","affiliation":[{"name":"Department of Medicine, Northwestern University, Chicago, Illinois, USA"}]},{"suffix":"IV","given":"Thomas F","family":"Byrd","sequence":"additional","affiliation":[{"name":"Department of Medicine, Northwestern University, Chicago, Illinois, USA"}]},{"given":"Preeti","family":"Kansal","sequence":"additional","affiliation":[{"name":"Department of Medicine, Northwestern University, Chicago, Illinois, USA"}]},{"given":"Cheryl","family":"Wilkes","sequence":"additional","affiliation":[{"name":"Department of Medicine, Northwestern University, Chicago, Illinois, USA"}]},{"given":"Suzanne","family":"Falck","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA"}]},{"given":"Connie","family":"Larson","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, Illinois, USA"}]},{"given":"John","family":"Shilka","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, Illinois, USA"}]},{"given":"Elizabeth","family":"VanDril","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, Illinois, USA"}]},{"given":"Gordon D","family":"Schiff","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital Center for Patient Safety Research, Harvard Medical School Center for Primary Care, Boston, Massachusetts, USA"}]},{"given":"William L","family":"Galanter","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA"},{"name":"Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, Illinois, USA"},{"name":"Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, Illinois, USA"}]},{"given":"Bruce L","family":"Lambert","sequence":"additional","affiliation":[{"name":"Center for Communication and Health, Department of Communication Studies, Northwestern University, Chicago, Illinois, USA"}]}],"member":"286","published-online":{"date-parts":[[2021,12,27]]},"reference":[{"issue":"6","key":"2022041311581577700_ocab285-B1","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/S0097-5990(16)30214-7","article-title":"Quality ambulatory care: The role of the diagnostic and medication summary lists","volume":"14","author":"Benson","year":"1988","journal-title":"QRB Qual Rev Bull"},{"issue":"2","key":"2022041311581577700_ocab285-B2","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1111\/j.1525-1497.2005.40206.x","article-title":"Clinical implications of an accurate problem list on heart failure treatment","volume":"20","author":"Hartung","year":"2005","journal-title":"J Gen Intern Med"},{"issue":"10","key":"2022041311581577700_ocab285-B3","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1016\/j.ijmedinf.2015.06.011","article-title":"Problem list completeness in electronic health records: a multi-site study and assessment of success factors","volume":"84","author":"Wright","year":"2015","journal-title":"Int J Med Inform"},{"issue":"8","key":"2022041311581577700_ocab285-B4","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1093\/jamia\/ocaa125","article-title":"Characterizing outpatient problem list completeness and duplications in the electronic health record","volume":"27","author":"Wang","year":"2020","journal-title":"J Am Med Inform Assoc"},{"issue":"4","key":"2022041311581577700_ocab285-B5","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1136\/amiajnl-2011-000521","article-title":"Improving completeness of electronic problem lists through clinical decision support: a randomized, controlled trial","volume":"19","author":"Wright","year":"2012","journal-title":"J Am Med Inform Assoc"},{"issue":"5","key":"2022041311581577700_ocab285-B6","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/j.ijmedinf.2008.05.005","article-title":"Computerized physician order entry of medications and clinical decision support can improve problem list documentation compliance","volume":"79","author":"Galanter","year":"2010","journal-title":"Int J Med Inform"},{"issue":"10","key":"2022041311581577700_ocab285-B7","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1016\/j.ijmedinf.2013.07.003","article-title":"A trial of indication based prescribing of antihypertensive medications during computerized order entry to improve problem list documentation","volume":"82","author":"Falck","year":"2013","journal-title":"Int J Med Inform"},{"issue":"3","key":"2022041311581577700_ocab285-B8","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1136\/amiajnl-2012-001555","article-title":"Indication-based prescribing prevents wrong-patient medication errors in computerized provider order entry (CPOE)","volume":"20","author":"Galanter","year":"2013","journal-title":"J Am Med Inform Assoc"},{"issue":"7","key":"2022041311581577700_ocab285-B9","doi-asserted-by":"crossref","first-page":"e101977","DOI":"10.1371\/journal.pone.0101977","article-title":"Indication alerts intercept drug name confusion errors during computerized entry of medication orders","volume":"9","author":"Galanter","year":"2014","journal-title":"PLoS One"},{"issue":"1","key":"2022041311581577700_ocab285-B10","doi-asserted-by":"crossref","first-page":"94","DOI":"10.4338\/ACI-2010-11-RA-0072","article-title":"A trial of inpatient indication based prescribing during computerized order entry with medications commonly used off-label","volume":"2","author":"Walton","year":"2011","journal-title":"Appl Clin Inform"},{"key":"2022041311581577700_ocab285-B11","year":"2021"},{"issue":"7","key":"2022041311581577700_ocab285-B12","doi-asserted-by":"crossref","first-page":"559","DOI":"10.2165\/11534580-000000000-00000","article-title":"Enhancing pharmacosurveillance with systematic collection of treatment indication in electronic prescribing: A validation study in Canada","volume":"33","author":"Eguale","year":"2010","journal-title":"Drug Saf"},{"issue":"7","key":"2022041311581577700_ocab285-B13","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/j.ijmedinf.2011.03.014","article-title":"Using electronic medical records to determine the diagnosis of clinical depression","volume":"80","author":"Trinh","year":"2011","journal-title":"Int J Med Inform"},{"issue":"5","key":"2022041311581577700_ocab285-B14","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1093\/jamia\/ocx154","article-title":"Impact of problem-based charting on the utilization and accuracy of the electronic problem list","volume":"25","author":"Li","year":"2018","journal-title":"J Am Med Inform Assoc"},{"issue":"5","key":"2022041311581577700_ocab285-B15","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1197\/jamia.M3111","article-title":"Clinical decision support capabilities of commercially-available clinical information systems","volume":"16","author":"Wright","year":"2009","journal-title":"J Am Med Inform Assoc"}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jamia\/article-pdf\/29\/5\/909\/43372377\/ocab285.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jamia\/article-pdf\/29\/5\/909\/43372377\/ocab285.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T12:17:52Z","timestamp":1649852272000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/29\/5\/909\/6484443"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,27]]},"references-count":15,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,12,27]]},"published-print":{"date-parts":[[2022,4,13]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocab285","relation":{},"ISSN":["1527-974X"],"issn-type":[{"value":"1527-974X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,5,1]]},"published":{"date-parts":[[2021,12,27]]}}}