发表机构
Nanyang Business School, Nanyang Technological University; HealthPlix（南洋商学院，南洋理工大学; HealthPlix）
机构由 AI 辅助整理，请以论文原文为准。AI 中文总结
通过印度电子病历平台的随机现场实验，发现非强制性实时信息干预使药物相互作用错误减少8.6%，节省约480万美元并挽救约134人生命，其效果源于反应性纠正与主动性学习两种机制。
AI 中文摘要
药物相互作用（DDI）错误对患者安全构成严重风险。现有的决策支持系统通常要求医生对警报做出响应，这扰乱了工作流程并导致高覆盖（override）率。我们研究非强制性信息干预是否能减少DDI错误并促进学习。利用与印度最大的电子病历平台合作开展的随机现场实验，我们采用双重差分设计分析了来自1700名医生的281万张处方。治疗组医生收到实时信息，突出显示DDI错误，但不要求其做出响应，而对照组医生未收到此类信息。该干预使DDI错误减少了8.6%，相当于每年节省约480万美元的住院费用，并可能挽救约134人的生命。我们识别出两种机制：反应性纠正，即医生在错误被标记后予以移除；以及主动性学习，即医生在警报出现前避免错误。虽然早期的减少主要由纠正驱动，但随着时间的推移，医生越来越多地避免错误。他们重复先前被标记错误的可能性也降低，并减少了新错误，这表明学习泛化到了特定药物组合之外。这些效应在各类医生中保持一致，且未损害生产力或护理质量。我们的研究结果表明，非强制性信息干预可以通过即时错误纠正和持久、可泛化的学习来改善患者安全。
英文摘要
Drug-drug interaction (DDI) errors pose serious risks to patient safety. Existing decision-support systems often require physicians to respond to alerts, disrupting workflows and contributing to high override rates. We examine whether a non-mandatory information intervention can reduce DDI errors and foster learning. Using a randomized field experiment with India's largest electronic medical record platform, we analyze 2.81 million prescriptions from 1,700 physicians using a difference-in-differences design. Treatment physicians received real-time information highlighting DDI errors without being required to respond, while control physicians received no such information. The intervention reduced DDI errors by 8.6%, corresponding to an estimated US$4.8 million in annual hospitalization cost savings and approximately 134 lives potentially saved. We identify two mechanisms: reactive correction, whereby physicians remove errors after they are flagged, and proactive learning, whereby they avoid errors before alerts occur. While early reductions are driven primarily by correction, physicians increasingly avoid errors over time. They also become less likely to repeat previously flagged errors and reduce new errors, suggesting that learning generalizes beyond specific drug pairs. The effects are consistent across physician types and do not compromise productivity or care quality. Our findings show that non-mandatory information interventions can improve patient safety through both immediate error correction and persistent, generalizable learning.
