Effectively evaluating the appropriateness of clinical decision support (CDS) alerts and responses is critical to improving patient safety through health information technology. We describe the use of REDCap to create a data collection instrument for evaluating the appropriateness of CDS alerts and responses. While the tool is effective, further enhancements to REDCap would improve the process for future evaluations.

1. Computerized alerts that warn clinicians
about drug interactions or provide dosing
guidance are commonly implemented forms
of CDS to improve patient safety. Alert
overrides can hinder provider effectiveness
and result in adverse patient outcomes.
Few have described the processes for
performing necessary detailed evaluations
of the appropriateness of CDS alerts and
clinician responses.
Background
Using REDCap to Evaluate Clinical Decision Support Alert Appropriateness
Allison B. McCoy, PhD1,2, Eric J. Thomas, MD, MPH3, Marie Krousel-Wood, MD, MSPH1,2, Dean F. Sittig, PhD3
1Tulane University School of Public Health and Tropical Medicine, 2Center for Health Research, Ochsner Health System, New Orleans, LA
3The University of Texas Health Science Center at Houston, Houston, TX
Based on our previously described
framework for evaluating the CDS alert and
response appropriateness, we developed an
assessment tool using REDCap (Research
Electronic Data Capture), a secure, web-
based application designed to support data
capture for research studies.
Methods
We successfully used REDCap to create a
data collection instrument to facilitate
evaluation of CDS alert and response
appropriateness through chart review by
clinicians. Further enhancements to
REDCap, such as the ability to import data
with dual data entry, would improve the
process for future evaluations.
Conclusion
REDCap facilitated quick, easy development
of a HIPAA-compliant data collection tool
that is simple for clinicians to use. Because
data importing and dual data entry could
not be used together, we created data
access groups for reviewers; assigned alerts
a separate, unique identifier for each
reviewer; then assessed agreement and
merged responses outside of the REDCap
system.
ResultsREDCap Data Collection Instrument
Effectively evaluating the appropriateness
of clinical decision support (CDS) alerts
and responses is critical to improving
patient safety through health information
technology. We describe the use of
REDCap to create a data collection
instrument for evaluating the CDS alert
and response appropriateness.
Overview
This work was supported by NLM Grant
1K22LM011430-01A1, UTHealth Young Clinical
and Translational Sciences Investigator Award
KL2TR000370-06A1, and NCRR Grant
3UL1RR024148.
Please contact the corresponding author at:
amccoy1@tulane.edu
Acknowledgments
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