Appl Clin Inform 2011; 02(01): 50-62
DOI: 10.4338/ACI-2010-04-RA-0026
Research Article
Schattauer GmbH

Towards Meaningful Medication-Related Clinical Decision Support: Recommendations for an Initial Implementation

S. Phansalkar
1   Division of General Internal Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
2   Partners HealthCare System, Wellesley, MA
A. Wright
1   Division of General Internal Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
2   Partners HealthCare System, Wellesley, MA
G.J. Kuperman
3   New York-Presbyterian Hospital, New York, NY
A.J. Vaida
4   Institute for Safe Medication Practices, Huntingdon Valley, PA
A.M. Bobb
5   Northwestern Memorial Hospital, Chicago, IL
R.A. Jenders
6   National Library of Medicine, US National Institutes of Health, Bethesda, USA
10   Georgetown University. Washington, DC
T.H. Payne
7   Biomedical and Health Informatics, and UW Medicine Information Technology Services, University of Washington, Seattle, WA
J. Halamka
8   Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, MA
M. Bloomrosen
9   The American Medical Informatics Association, Bethesda, MD
D.W. Bates
1   Division of General Internal Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
2   Partners HealthCare System, Wellesley, MA
› Author Affiliations
Further Information

Publication History

received: 28 April 2010

accepted: 24 January 2011

Publication Date:
16 December 2017 (online)


Clinical decision support (CDS) can improve safety, quality, and cost-effectiveness of patient care, especially when implemented in computerized provider order entry (CPOE) applications. Medication-related decision support logic forms a large component of the CDS logic in any CPOE system. However, organizations wishing to implement CDS must either purchase the computable clinical content or develop it themselves. Content provided by vendors does not always meet local expectations. Most organizations lack the resources to customize the clinical content and the expertise to implement it effectively. In this paper, we describe the recommendations of a national expert panel on two basic medication-related CDS areas, specifically, drug-drug interaction (DDI) checking and duplicate therapy checking. The goals of this study were to define a starter set of medication-related alerts that health-care organizations can implement in their clinical information systems. We also draw on the experiences of diverse institutions to highlight the realities of implementing medication decision support. These findings represent the experiences of institutions with a long history in the domain of medication decision support, and the hope is that this guidance may improve the feasibility and efficiency CDS adoption across healthcare settings.

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