title: Improving Medication Adherence in a Regional Healthcare Information Exchange using a Scalable, Claims-Driven, and Service-Oriented Approach.
abstract: Evidence-based pharmacotherapy is a central aspect of optimal patient care for many chronic conditions. However, medication non-adherence frequently inhibits the attainment of optimal pharmacotherapy regimens. In this study, we designed, developed, and implemented a multifaceted clinical decision support (CDS) intervention that supports evidence-based pharmacotherapy and enhanced medication adherence through the use of a scalable, claims-driven, and service-oriented approach. The intervention includes a medication management report and a low adherence alert based on thirteen evidence-based pharmacotherapy rules for seven chronic conditions. Reports and alerts are delivered to primary care clinics and care managers that participate in a healthcare information exchange in North Carolina. The resulting system architecture may enable this CDS intervention to be widely disseminated to healthcare networks through an open-source model.
authors.affiliation: Division of Clinical Informatics, Department of Community and Family Medicine and.
authors.forename: Guilherme
authors.initials: G
authors.lastname: Del Fiol
authors.forename: Kensaku
authors.initials: K
authors.lastname: Kawamoto
authors.forename: Nancy M Allen
authors.initials: NM
authors.lastname: Lapointe
authors.forename: Eric L
authors.initials: EL
authors.lastname: Eisenstein
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Anstrom
authors.forename: Laura L
authors.initials: LL
authors.lastname: Wood
authors.forename: David F
authors.initials: DF
authors.lastname: Lobach
mesh_terms: D002908:Chronic Disease; D003199:Computer Systems; D020000:Decision Support Systems, Clinical; D006801:Humans; D055118:Medication Adherence