Efficacy and unintended consequences of hard-stop alerts in electronic health record systems: a systematic review

摘要

Clinical decision support (CDS) hard-stop alerts—those in which the user is either prevented from taking an action altogether or allowed to proceed only with the external override of a third party—are increasingly common but can be problematic. To understand their appropriate application, we asked 3 key questions: (1) To what extent are hard-stop alerts effective in improving patient health and healthcare delivery outcomes? (2) What are the adverse events and unintended consequences of hard-stop alerts? (3) How do hard-stop alerts compare to soft-stop alerts?