AI systems in clinical practice

Laboratory systems
PharmADE
Pharmacy Adverse Drug Event
Hospital pharmacy expert system for monitoring Adverse Drug Events

developed by clinical domains keywords
Barnes-Jewish Hospital Pharmacy Department and Medical Informatics researchers, Washington University, St. Louis hospital monitoring Adverse Drug Events Expert systems, knowledge-based systems
location commissioned status
Barnes-Jewish and St. Louis Children's Hospitals; Washington University Medical Center Barnes-Jewish Hospital in January 1996; Christian Hospital, St. Louis in the spring of 2000; Missouri Baptist Medical Center in November 2001. In clinical use
description

PharmADE monitors the care of patients by screening for medication orders that might interact with other medications already administered to the patient. Currently, over 120 contraindicated drug combinations are included in the system, and new contraindications can be added within days of their discovery. Reports and alerts are both printed and made available through a web-based interface developed using Sybase's WEB.SQL product. PharmADE detected 110 potentially lethal drug combinations over a 15 month period.

references

McMullin ST, Reichley RM, Watson LA, Steib SA, Frisse ME, Bailey TC. Impact of a Web-based clinical information system on cisapride drug interactions and patient safety. Arch Intern Med. 1999 Sep 27;159(17):2077-82.

[PubMed]   [Arch Intern Med.]

" BACKGROUND: Most commercially available drug-interaction screening systems have important limitations that fail to protect patients from dangerous drug combinations. We attempted to overcome the limitations of our commercial program by developing a Web-based clinical information system to serve as a safety net. This system identifies drug interactions with newly marketed medications not screened by our commercial program, and generates a second alert on dangerous interactions that were overridden during order processing. METHODS: The Web-based system uses patient-specific pharmacy, laboratory, and demographic data to generate detailed alerts on patients receiving potentially dangerous drug combinations. The system's impact on the use of dangerous drug combinations and related adverse events was evaluated by a retrospective analysis of patients receiving cisapride with contraindicated medications in the 2 years before and after implementation. ... CONCLUSIONS: An automated system running as a safety net can be an efficient method of detecting contraindicated drug combinations and serves an important role in the avoidance of potentially serious adverse drug events. "

Miller JE, Reichley RM, McNamee LA, Steib SA, Bailey TC. Notification of real-time clinical alerts generated by pharmacy expert systems. Proc AMIA Symp. 1999;:325-9.

[PubMed]   [AMIA]

" We developed and implemented a strategy for notifying clinical pharmacists of alerts generated in real-time by two pharmacy expert systems: one for drug dosing and the other for adverse drug event prevention. Display pagers were selected as the preferred notification method and a concise, yet readable, format for displaying alert data was developed. This combination of real-time alert generation and notification via display pagers was shown to be efficient and effective in a 30-day trial. "

contact links

Washington University School of Medicine
Department of Internal Medicine
Division of Medical Informatics
660 South Euclid Campus
Box 8005 St. Louis
Missouri 63110 USA.

 bullet  Medical Informatics at Washington University in St. Louis  bullet  Barnes and Jewish Hospitals, St. Louis  bullet  BJC Healthcare  bullet  St. Louis Children's Hospital - BJC HealthCare Quality Initiatives
acknowledgements

 

Entry on OpenClinical: 23 January 2005
Last main update: 23 January 2005
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