Computerized insulin order sets can lead to unanticipated consequences

McKenzie Bedra, Sherita Hill Golder, Eunme Cha, In Cheol Jeong, Joseph Finkelstein

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Computerized order sets for medication management were recently shown to be associated with increased patient safety risks in primary care setting. This study was aimed at demonstrating similar phenomenon in a hospital setting. After introduction of computerized order set targeting hypoglycemia, the frequency of hypoglycemia significantly decreased from 1/1/07 to 12/31/08. However, the frequency of hyperglycemia also increased at the same time from 1/1/07 to 12/31/07. Only after subsequent introduction of a hospital-wide standardized insulin order set including hyperglycemia policies, the frequency of hyperglycemic episodes declined. Hypo/hyperglycemia is associated with adverse clinical outcomes in the inpatient setting. Retroactive analysis showed that if hypoglycemic and hyperglycemic policies were introduced simultaneously, unexpected increase in frequency of hyperglycemic episodes could have been avoided. These data are informative in identifying unanticipated consequences of an insulin management order sets focused entirely on hypoglycemia. A balanced approach in implementing insulin management EMR order sets that concurrently addresses both hypoglycemia and hyperglycemia policies is warranted.

Original languageEnglish (US)
Title of host publicationEnabling Health Informatics Applications
EditorsJohn Mantas, Mowafa S. Househ, Arie Hasman
PublisherIOS Press
Pages53-56
Number of pages4
ISBN (Electronic)9781614995371
DOIs
StatePublished - Jan 1 2015
Event13th International Conference on Informatics, Management, and Technology in Healthcare, ICIMTH 2015 - Athens, Greece
Duration: Jul 9 2015Jul 11 2015

Publication series

NameStudies in Health Technology and Informatics
Volume213
ISSN (Print)0926-9630
ISSN (Electronic)1879-8365

Other

Other13th International Conference on Informatics, Management, and Technology in Healthcare, ICIMTH 2015
Country/TerritoryGreece
CityAthens
Period7/9/157/11/15

Keywords

  • Clinical guidelines
  • Hyperglycemia
  • Hypoglycemia
  • Order sets

ASJC Scopus subject areas

  • Biomedical Engineering
  • Health Informatics
  • Health Information Management

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