Meaningful Drug Interaction AlertsProject Summary:Clinical decision support (CDS) for electronic health records (EHR) and prescribing systems has beenpromoted to improve patient outcomes. One type of CDS are drug-drug interaction (DDI) alerts. The Office ofthe National Coordinator for Health IT meaningful use criteria includes the implementation of DDI detection andwarnings to physicians and other healthcare professionals. Nearly all healthcare organizations rely on DDIalerts generated from commercial drug knowledge databases. Warnings are currently generated using simpledrug combination rules ignoring drug attributes and the wealth of information available in the EHR that couldmake the warnings specific to the patient. As a result providers are bombarded with useless warnings andoften miss important ones.Our approach is to change the framework for DDI alerting from basic look-up tables to a more complex butmeaningful clinical algorithms. Our plan is innovative because it will: 1) eliminate alerts for DDIs that are notclinically important given the patient and drug context; 2) develop implementable and tested algorithms usingexisting and new evidence; and 3) support the dissemination implementation and evaluation of thesealgorithms across the spectrum of healthcare facilities and organizations. The central hypothesis of thisproject is that individualizing DDI alerts to specific patient circumstances will result in a much greater proportionof alerts that physicians pharmacists and other healthcare providers will be more likely to heed. We willaccomplish our objectives and test our hypothesis by pursuing the following aims:Specific Aim 1: Design sharable evidence-based individualized DDI algorithms that capitalize on the wealth ofpatient data located within electronic health records;Specific Aim 2: Validate the function of newly designed DDI algorithms using electronic health record data;andSpecific Aim 3: Conduct a prospective evaluation of DDI algorithms in a variety of healthcare environmentsincluding ambulatory and institutional settings.This project will greatly improve CDS for DDIs by incorporating contextual factors into evidence-based andvalidated alert algorithms which will reduce alert fatigue and result in more meaningful CDS. Our approachinvolving partners across multiple organizations and environments and experts in drug interaction andbiomedical informatics will result in safer healthcare with respect to the use of medications.