Endorsement, Prior Action, and Language: Modeling Trusted Advice in Computerized Clinical Alerts

Abstract

The safe prescribing of medications via computerized physician order entry routinely relies on clinical alerts. Alert compliance, however, remains surprisingly low, with up to 95% often ignored. Prior approaches, such as improving presentational factors in alert design, had limited success, mainly due to physicians' lack of trust in computerized advice. While designing trustworthy alert is key, actionable design principles to embody elements of trust in alerts remain little explored. To mitigate this gap, we introduce a model to guide the design of trust-based clinical alerts-based on what physicians value when trusting advice from peers in clinical activities. We discuss three key dimensions to craft trusted alerts: using colleagues' endorsement, foregrounding physicians' prior actions, and adopting a suitable language. We exemplify our approach with emerging alert designs from our ongoing research with physicians and contribute to the current debate on how to design effective alerts to improve patient safety.