Have our hospitals already adequately addressed this problem?
You can open SUNRISE to a patient from "floor" thirteen", or CPRS to any patient whose name stats with "ZZZ" and explore the CPOE and alerts to see how our hospital handles the problem you are interested in.
2. Searching for evidence
The following evidence is needed
Identifying the patients at risk of your disease.
Determining the best intevention.
Suggestion:
Spiffing up your computer with bookmarklets (especially the one to "proxy me") and browser search plugins (especially the ones for PubMed).
Start your search with a high quality systematic hypertext book. Either Clinical Evidence (I have copies of this), PIER, or UpToDate.
Note that the more ways in which you intervene (including non-electronic ways), the more impact you will likely have (Ann Int Med 2005. PMID: 16365469).
EHR software places restrictions on your design. For this exercise, use powerpoint or the equivalent to design any interface you want. The interface could be used as a templage for order entry, a clinical reminder, or other purpose.
Good guides to designing the interface is:
Bates DW et al. Ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality. J Am Med Inform Assoc. 2003;10:523-30.
PMID: 12925543 (free full text in PubMed Central)
Nielsen, Jakob (April 11, 2005). Medical Usability: How to Kill Patients Through Bad Design (Jakob Nielsen's Alertbox). .
Remember, a bad design can
Hurt a patient:
Faron M et al. The pitfalls of introducing electronic medical records. Ann Intern Med. 2006 Feb 7;144(3):220. PMID: 16461973
Wachter RM. Expected and unanticipated consequences of the quality and information technology revolutions. JAMA 2006. PMID: 16788133
Han YY et al. Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system. Pediatrics 2006. PMID: 16322178
