Study On Evaluation Of Safety Warning System Based On Medical Alliance Platform

The problem of drug safety has threatened human health seriously. With the development of information technology, using information technology to promote rational drug use and improve drug safety has become an international trend. In2010, innovative practice in Shanghai about drug safety alert system based on hospital link Platform achieves rational drug alert and recent diagnosis and treatment item alert across hospitals and provides reliable technical supports to promote rational drug use. According to the requirements of shanghai health care reform, it will start the construction of health information engineering project (Health Information Network), and the drug safety alert system based on hospital link Platform will be applied to Healthcare Information Network and promoted in the municipal hospitals in Shanghai. It is necessary to evaluate the system.Objective:we need to systematically evaluate the application status of the drug safety alert system based on hospital link Platform, identify the actual problems currently in the process, analyze the obstacles of the application, study and put forward proposals to optimize the system and provide reliable basis to further improve the system.Methods:①By means of literature review, to have a good understanding of the domestic research of rational drug use and the evaluation methods of information system application;②By drawing on the RE-AIM framework, to make research designs and specific assessment strategies.③By using23hospitals’datas which produced in the system logs and the statistic analysis application module of the drug safety alert system based on hospital link Platform, to investigate the application of the system.④By using a questionnaire survey, to understand the satisfaction and barriers of clinicians on the application of system.⑤By interviewing with key informants to further understand barriers of application at the policy level and other.⑦By using SPSS, finish data processing and statistical analysis.Results:1. The object and range covered by system:The system has covered municipal hospitals which are connected to Shanghai hospital-link System. The system has been installed on the2953(79.34%) clinical PC workstations in the out-patient of the municipal hospitals, which effeccts the system’s availability to some extent.2. The effect of application:The system implements four types of warning functions, prompts3070400warning messages in the municipal hospitals. The overall warning rate was17.17%. The four types of warning rate from high to low successively were similar medicine, rational drug use, similar test and similar examination. The warning rate among every hospital and different types of hospitals were quite different. Part of the warning messages were obeyed, the whole times of obeying were187500times and the overall obey rate was6.11%. The obey rate of the four types of warning messages from high to low successively were similar test, similar medicine, rational drug use and similar examination. The obey rates were quite different among every hospital and various types of hospitals.3. Customer satisfaction:More than87%of the respondents (clinicians) understand the system and over60%of the respondents usually pay attention to the warning messages. Users are generally satisfied with the application of the system and they think it is very useful, effective, easy to use and convenient, and especially play a positive role in guaranteeing medical security and controlling medical cost reasonably.4. The barriers and suggestions of application:It mainly contains systemic factors, political factors and doctors’personal factors; In terms of system’s suggestions, more than85%of the respondents think that warning items can satisfy the needs of clinical practice and it doesn’t need to be adjusted. The respondents generally hope to show the warning items by classification, implement the warning flexibly, are not in favor of implementing the warning by force and department directors have stronger desires to implement the warning flexibly.Optimization suggestion:1, Optimize the performance of the system. On the one hand, to improve positively the hospital informatization level, improve the system’s hardware and network environment, extend the application range of clinical workstations in out-patient and improve the access to system application. On the other hand, further optimize data extraction, data cleaning, response time, response efficiency and so on. In addition, optimize the user interface of the system, warning method and warning time to satisfy the need of users through using the way of UserDriven.2. Improve the knowledge base and discrimination rule. The knowledge base should be updated thoroughly and punctually. The discrimination rule should be rational and give consideration to specificity and sensitivity that should be improved appropriately.3. Seize the opportunity of medical reform and create a political environment. Catch the opportunity of implementing Medicare Prospective Payment System and improving hospital compensation mechanism step by step, change the hospital operating mechanism, adjust the motivate mechanism and create a favorable political environment for the application of the system.4. Strengthen the promotion and guidance on hospital and improve the monitoring method. Guide municipal hospitals and clinicians to use the system through strengthening promotion, improve the system background’s function of auditing and monitoring and create a closed loop.