The alert informs the provider that the free-text justification he or she provides will be inserted into the patient's medical record where other providers can see it, and that if he or she does not enter a justification, the statement "No justification for prescribing antibiotics was given" will be entered into the patients' medical record.
The clinician must write his or her justification for prescribing the antibiotic in a free-text field in the EHR; no pre-written justifications are given.
For clinicians randomized to the Accountable Justification arm, we will use qualitative methods to analyze the content of their written justifications for prescribing antibiotics to patients with ARIs.
One is justification, which refers to prescribing a CT exam only when it is medically necessary.
Furthermore, the diagnosis of diseases is generally presumptive; a few antimicrobials (penicillin G, penicillin-streptomycin combination and oxytetracycline) are frequently prescribed with little justifications [ 36], and across the Ethiopia-Kenya border, community based workers account for 83.8% (140/167) of the health care service providers [ 44].
In the Accountable Justifications intervention, clinicians are prompted to record an explicit justification for why they are prescribing an antibiotic to a patient with an ARI that appears in the patient's EHR.
Guideline-concordant treatment choices (i.e., not prescribing an antibiotic for an ARI) continue to require no special justification, but a provider must now "opt-in" to prescribing an antibiotic by providing a justification for which they are accountable.
Using the final codings, we will examine the distribution of justification codes in conjunction with clinicians' antibiotic prescribing rates and quantify the extent to which persistent ARI antibiotic prescribing among Accountable Justifications clinicians is well-justified (i.e., prescribing that is either concordant with guidelines or for patients who are excluded from guidelines).
If we were psychiatrists, we'd need little justification to prescribe any drug that might help alleviate her suffering.
Furthermore, paricalcitol is more expensive than alfacalcidol and needs greater justification if prescribed.
