Detection of potential drug-drug interactions for outpatients across hospitals.
The National Health Insurance Administration (NHIA) has adopted smart cards (or NHI-IC cards) as health cards to carry patients' medication histories across hospitals in Taiwan. The aims of this study are to enhance a computerized physician order entry system to support drug-drug interaction (DDI) checking based on a patient's medication history stored in his/her NHI-IC card. For performance evaluation, we developed a transaction tracking log to keep track of every operation on NHI-IC cards. Based on analysis of the transaction tracking log from 1 August to 31 October 2007, physicians read patients' NHI-IC cards in 71.01% (8,246) of patient visits; 33.02% (2,723) of the card reads showed at least one medicine currently being taken by the patient, 82.94% of which were prescribed during the last visit. Among 10,036 issued prescriptions, seven prescriptions (0.09%) contained at least one drug item that might interact with the currently-taken medicines stored in NHI-IC cards and triggered pop-up alerts. This study showed that the capacity of an NHI-IC card is adequate to support DDI checking across hospitals. Thus, the enhanced computerized physician order entry (CPOE) system can support better DDI checking when physicians are making prescriptions and provide safer medication care, particularly for patients who receive medication care from different hospitals.
Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, 250 Wuhsing St., Taipei 110, Taiwan. ting@shh.org.tw.
Yu-Ting
YT
Yeh
Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, 250 Wuhsing St., Taipei 110, Taiwan. ccnsdoctor@mohw.gov.tw.
Min-Hui
MH
Hsu
Department of Information Management, Wan Fang Hospital, Taipei Medical University, Section 3, 111 HsingLong Rd., Taipei 116, Taiwan. cychen12@vghtpe.gov.tw.
Chien-Yuan
CY
Chen
Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, 250 Wuhsing St., Taipei 110, Taiwan. loyusen@gmail.com.
Yu-Sheng
YS
Lo
Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, 250 Wuhsing St., Taipei 110, Taiwan. ctliu@tmu.edu.tw.
Chien-Tsai
CT
Liu
D001291:Attitude of Health Personnel; D004347:Drug Interactions; D006761:Hospitals / Q000592:standards*; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control*; D050316:Medical Order Entry Systems; D010045:Outpatients