WO2016077697A1 - Preemptive drug interaction and drug allergy alerts - Google Patents
Preemptive drug interaction and drug allergy alerts Download PDFInfo
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- WO2016077697A1 WO2016077697A1 PCT/US2015/060582 US2015060582W WO2016077697A1 WO 2016077697 A1 WO2016077697 A1 WO 2016077697A1 US 2015060582 W US2015060582 W US 2015060582W WO 2016077697 A1 WO2016077697 A1 WO 2016077697A1
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H70/00—ICT specially adapted for the handling or processing of medical references
- G16H70/40—ICT specially adapted for the handling or processing of medical references relating to drugs, e.g. their side effects or intended usage
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
- G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
- G16H20/10—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients
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- General Health & Medical Sciences (AREA)
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- Public Health (AREA)
- Chemical & Material Sciences (AREA)
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Abstract
The present disclosure provides a system and method for preemptive, pre-contemplation prescriber warnings to prevent use of an available treatment plan that could negatively impact a patient based on the patient's health record. Systems for preemptive, pre-contemplation prescriber warnings comprising a storage medium for at least one patient health record, a first computing device capable of receiving a patient health record, and software, wherein the software is configured to provide a preemptive, pre-contemplation notification to a provider when an available medical order could negatively impact a patient are provided.
Description
PREEMPTIVE DRUG INTERACTION AND DRUG ALLERGY ALERTS
FIELD
[0001] The present disclosure relates generally to systems and methods that provide preemptive, pre-contemplation notifications and advice to clinicians making treatment decisions.
BACKGROUND
[0002] Electronic prescribing systems that use clinical decision support ("CDS") software help prescribers, such as doctors and other clinicians, prescribe medicines and other treatments in a safe manner. These electronic prescribing systems warn prescribers about potential negative interactions, allergies, and other dangers if a prescriber is about to prescribe a new treatment to a patient with a pre-existing condition or pre-existing treatment regime that could interact negatively with a newly- prescribed medicine or treatment. [0003] However, there are deficiencies in current electronic prescribing systems, such as systems generating too many alerts, not enough alerts, and/or alerts that lack emphasis. For example, in a system that generates alerts in every instance when a doctor is about to prescribe a prescription drug or other treatment, the doctor may suffer from alert fatigue, wherein the doctor no longer pays attention to alerts and continues on a previously decided course of treatment. Too many alerts also cause unnecessary distractions for doctors and other prescribers. Oppositely, too few alerts can cause dangers to patients with risks for negative drug interactions and allergies.
[0004] Many drug safety alerts in electronic prescribing systems are overridden by prescribers, oftentimes inappropriately. Irrelevant and frequent alarms cause
practitioners to be desensitized to the alarms, and they are subsequently ignored and overridden. Furthermore, alerts provided to prescribers late in a diagnosis and prescription process may be less likely to change a proposed course of treatment than
when such alerts are provided to prescribers early in a diagnosis and prescription process.
[0005] Therefore, a useful electronic prescribing system should provide early preemptive warnings in a pre-contemplation stage of prescription, have high specificity, and have high sensitivity. High specificity refers to the ability of an electronic
prescribing system to provide only relevant, important alerts or warnings. High sensitivity refers to the ability of an electronic prescribing system to not miss or neglect any potential alerts for negative interactions or pre-existing patient conditions. Many contemporary electronic prescription systems have high sensitivity, but low specificity. Furthermore, the information provided in an alert should be accurate and be provided to the correct prescriber, without providing irrelevant information or needless distractions.
[0006] A useful electronic prescribing system should also take into account human factors such as alarm or alert placement, visibility, design, color, and user- customizability. Alerts and alarms on electronic systems are oftentimes boring, confusing, difficult to see, and therefore, overall frustrating to prescribers such as doctors. Ultimately, such alerts in electronic prescribing systems are only helpful if they allow a doctor or other prescriber to avoid a negative impact on a patient.
[0007] Therefore, there is a need for an electronic prescribing system that provides preemptive alerts or alarms to prescribers early in the diagnosis and prescription process when the prescriber is in a pre-contemplation stage regarding treatment options. The system should provide early, easy to understand, and accurate alerts or alarms specific to an individual patient.
SUMMARY
[0008] Systems for preemptive, pre-contemplation prescriber warnings comprising a storage medium for at least one patient health record, a first computing device capable of receiving a patient health record, and software, wherein the software is configured to
provide a preemptive, pre-contemplation notification to a provider when an available medical order could negatively impact a patient are provided.
[0009] Also provided are methods for providing preemptive, pre-contemplation warnings including receiving a patient health record, comparing the patient health record to available medical ordering options to determine any potential negative effects of the options to the patient, and providing a preemptive, pre-contemplation warning to a provider of the potential negative effects.
[0010] The present disclosure is also directed toward systems for providing preemptive treatment safety alerts to prescribers in a pre-contemplation stage of the diagnosis and prescription process.
[0011] As used herein, the term "providers" can include any medical professional providing diagnostic, treatment, or other services. Accordingly, providers includes prescribers, which can include doctors, nurse practitioners, nurses, pharmacists and any other prescriber of over the counter medicines, prescription pharmaceuticals, medical treatments, or any other clinical decision.
[0012] As used herein, "pre-contemplation" may refer to a stage in the diagnosis and prescription process in which the prescriber has not already effectively decided on a treatment plan, or is influenced to choose amongst multiple available options, optionally in a list, by noticeable warnings. [0013] The system disclosed herein addresses the deficiencies in current alerts or alarms used in electronic prescription systems, such as alert fatigue, by providing an accurate, easy-to-understand, and early warning to a prescriber before the prescriber has made up his or her mind as to the treatment plan. Early advice provided to a prescriber by an alert or alarm is more likely to be used by a prescriber in making a treatment decision than post hoc warnings.
[0014] In some embodiments, upon loading a patient chart and/or patient health record, the system of the present disclosure pre-computes all possible drug orders or treatment plans for the patient and the warnings associated with each drug or treatment plan. In some embodiments, real-time display of warnings or alerts is enabled by having the patient information cached. The alerts, warnings, indications, alarms, or any other information relevant to the prescriber can be displayed into a dropdown menu, order set, and/or search bar.
[0015] In other embodiments, natural language processing ("NLP") can be used for note-based alerting. Thus, NLP may analyse a doctor's notes in real-time to assess for dangers to a patient in a proposed treatment plan, and warn the doctor or other prescriber as he or she is developing the treatment plan.
[0016] Disclosed herein is a system for preemptive, pre-contemplation prescriber warnings comprising a storage medium for at least one patient health record, a first computing device capable of receiving a patient health record, and software, wherein the software is configured to provide a preemptive, pre-contemplation warning to a prescriber when an available treatment plan would negatively impact a patient based on the patient health record. In some embodiments, the warning includes visual and audio alerts. In other embodiments, the warning is provided within an order set.
[0017] Also disclosed is a method for preemptive, pre-contemplation warning comprising receiving a patient health record, comparing the patient health record to available treatment options to determine any potential negative effects to the patient, and providing a preemptive, pre-contemplation warning to a prescriber.
BRIEF DESCRIPTION OF THE DRAWINGS
[0018] The features of this disclosure, and the manner of attaining them, will become more apparent and the disclosure itself will be better understood by reference to the following description of embodiments of the disclosure taken in conjunction with the accompanying drawings.
[0019] FIG. 1 is a screen shot of a traditional search bar for a prescriber while picking a medication;
[0020] FIG. 2 is a screen shot of a traditional alert or warning screen provided by electronic prescription software once the prescriber has selected a treatment; [0021] FIG. 3 is a screen shot of one exemplary embodiment of the preemptive, pre- contemplation alert system of the present disclosure;
[0022] FIG. 4 is a screen shot of one exemplary alert screen for interactions;
[0023] FIG. 5 is a screen shot of one exemplary alert screen for interactions and allergies; [0024] FIG. 6 is a screen shot of one exemplary embodiment of the preemptive, pre- contemplation alert system of the present disclosure being used within order sets;
[0025] FIG. 7 is a screen shot of an alert provided in real-time to a prescriber during note writing by using NLP software;
[0026] FIG. 8 illustrates an exemplary system for providing preemptive, pre- contemplation warnings to a provider and/or patient; and
[0027] FIG. 9 illustrates exemplary methods according to various embodiments.
[0028] Corresponding reference characters indicate corresponding parts throughout the several views. Although the drawings represent embodiments of the present disclosure, the drawings are not necessarily to scale and certain features may be exaggerated in order to better illustrate and explain the present disclosure. The exemplifications set out herein illustrate an exemplary embodiment of the disclosure, in one form, and such exemplifications are not to be construed as limiting the scope of the disclosure in any manner.
DETAILED DESCRIPTION OF THE DRAWINGS
[0029] The embodiments disclosed herein are not intended to be exhaustive or limit the disclosure to the precise form disclosed in the following detailed description.
Rather, the embodiments are chosen and described so that others skilled in the art may utilize their teachings.
[0030] One of ordinary skill in the art will realize that the embodiments provided can be implemented in hardware, software, firmware, and/or a combination thereof.
Programming code according to the embodiments can be implemented in any viable programming language such as C, C++, HTML, XTML, JAVA or any other viable high- level programming language, or a combination of a high-level programming language and a lower level programming language.
[0031] Referring first to FIG. 1 , a screen shot of a traditional search bar for a prescriber picking a medication during a diagnosis and prescription procedure is shown. As shown, a provider or prescriber, such as a doctor, would type a proposed treatment plan into search bar 100 and matching options 102 would be displayed below search bar 100. In the example shown, varieties of the prescription drug penicillin are shown, but any treatment such as non-prescription, over-the-counter drugs or other therapeutic options could appear in matching options 102. The prescriber could then select one of matching options 102, which would likely match whatever option the prescriber had pre- decided upon selecting, before typing into search bar 100. No warnings or alerts are provided at this stage.
[0032] Referring now to FIG. 2, a screen shot of a traditional alert or warning screen provided by electronic prescription software once the prescriber has selected a treatment is shown. In the embodiment shown, a post hoc allergy warning is displayed to the prescriber after the prescriber has selected Penicillin V. In traditional electronic prescription software, the prescriber can and oftentimes does override or ignore this
warning. For example, rather than selecting "Details" for opening information about the allergies, the prescriber can simply select "Continue Order."
[0033] Referring now to FIG. 3, a screen shot of one exemplary embodiment of the preemptive, pre-contemplation alert system of the present disclosure is shown. As shown, during or once the prescriber types into search bar 100, preemptive warnings 104 are provided before any particular selection is made. The provider or prescriber views preemptive notification (e.g., warning) 104 before any particular treatment decision is made.
[0034] Accordingly, within the scope of this disclosure are systems for preemptive, pre-contemplation prescriber warnings comprising a storage medium for at least one patient health record, a first computing device capable of receiving a patient health record, and software, wherein the software is configured to provide a preemptive, pre- contemplation notification to a provider when an available medical order could negatively impact a patient. [0035] In various embodiments, the preemptive, pre-contemplation notification (e.g., warning) may include visual alerts, audio alerts, or both. In various embodiments, the preemptive, pre-contemplation notification is not particularly limited and, thus, may be provided to a provider when the available medical order could negatively impact a patient based on a patient health record. Exemplary preemptive, pre-contemplation notifications include formulary information, insurance information, cost information, or warning information. Exemplary warning information can include allergy warnings, interaction warnings, or warnings regarding diagnostic procedures, such as warning the provider that metal is present in the patient during the pre-contemplation of a magnetic resonance imaging (MRI). [0036] Thus, the medical order is not particularly limited and may include diagnostic orders, treatments, or other medical orders. For example, the medical order may include diagnostic radiology, such as X-ray radiography, ultrasound, computed
tomography (CT), nuclear medicine including positron emission tomography (PET), and MRI.
[0037] Referring now to FIG. 4, a screen shot of one exemplary alert screen for negative interactions is shown. Interaction notifications and/or warnings 106 are shown, once again, before any particular selection is made by the prescriber.
[0038] Referring now to FIG. 5, a screen shot of one exemplary alert screen for interactions and allergies is shown. Both allergy and interaction warnings are showed simultaneously, once again, before any particular selection is made by the prescriber.
[0039] Referring now to FIG. 6, a screen shot is shown of one exemplary
embodiment of the preemptive, pre-contemplation alert system of the present disclosure being used within order sets. Allery warnings 610 and interaction warnings 620 are exemplified in FIG. 6 beside particular dosing schedules of certain drugs, and in this way can influence the prescribers before a particular drug choice and dosing schedule is selected. [0040] Referring now to FIG. 7, a screen shot is shown of an alert provided in realtime to a provider or prescriber during note writing by using NLP software. Prescriber note 108 is shown enlarged in FIG. 7, and with the use of NLP software, note 108 can be scanned to realize the doctor is considering "Amoxicillin for 10 days." Once the NLP software notes this in real-time, it can display warning window 110 before a treatment plan is finalized, because a potential allergy exists based upon the patient health record.
[0041] Referring now to FIG. 8, a system diagram is shown for one exemplary system for providing preemptive, pre-contemplation warnings to a prescriber and/or patient. Provider 112 views screen 116, and in some optional embodiments, patient 114 can view the same information from screen 116 on patient screen 118. The information viewed by prescriber 112 and/or patient 114 might be similar to any of the screen shots shown in FIGS. 3-7.
[0042] In the exemplary embodiment shown, first computing device 120 includes computer readable storage medium 122 and database 124. More or fewer databases are envisioned, and database 124 may be physically located within computer readable storage medium 122, but in other embodiments database 124 may be located within a cloud-based storage medium or other storage media. Database 124 includes patient health records such as drug allergies, pre-existing conditions, pre-existing prescriptions, pre-existing pharmaceutical sensitivities, and any other relevant medical data necessary for a prescriber to prescribe a treatment plan.
[0043] First computing device 120 is capable of capturing all of the relevant patient data and comparing the patient data to possible patient treatment options to develop necessary warnings in real-time to be displayed in a list or drop-down list. First computing device 120 is also capable of operating NLP software to evaluate prescriber notes in real-time to evaluate a potential treatment plan for associated risks.
[0044] The various systems, such as those exemplified in FIG. 8, can perform various embodiments that are within the scope of this disclosure. For example, the systems disclosed herein may perform various steps of the method illustrated in FIG. 9.
[0045] FIG. 9 illustrates method 900 for providing preemptive, pre-contemplation warnings according to various embodiments. Method 900 may include receiving a patient health record (step 910), comparing the patient health record to available medical ordering options to determine any potential negative effects of the options to the patient (step 920), and providing a preemptive, pre-contemplation warning to a provider (step 930), for example, of potential negative effects.
[0046] As described above, medical ordering options are not particularly limited and may include treatment options, prescription options, or diagnosis options, such as diagnostic radiology.
[0047] While this disclosure has been described as having an exemplary design, the present disclosure may be further modified within the spirit and scope of this
disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the disclosure using its general principles. Further, this application is intended to cover such departures from the present disclosure as come within known or customary practice in the art to which this disclosure pertains. [0048] Furthermore, the connecting lines shown in the various figures contained herein are intended to represent exemplary functional relationships and/or physical couplings between the various elements. It should be noted that many alternative or additional functional relationships or physical connections may be present in a practical system. However, the benefits, advantages, solutions to problems, and any elements that may cause any benefit, advantage, or solution to occur or become more
pronounced are not to be construed as critical, required, or essential features or elements. The scope is accordingly to be limited by nothing other than the appended claims, in which reference to an element in the singular is not intended to mean "one and only one" unless explicitly so stated, but rather "one or more." Moreover, where a phrase similar to "at least one of A, B, or C" is used in the claims, it is intended that the phrase be interpreted to mean that A alone may be present in an embodiment, B alone may be present in an embodiment, C alone may be present in an embodiment, or that any combination of the elements A, B or C may be present in a single embodiment; for example, A and B, A and C, B and C, or A and B and C. [0049] In the detailed description herein, references to "one embodiment," "an embodiment," "an example embodiment," etc., indicate that the embodiment described may include a particular feature, structure, or characteristic, but every embodiment may not necessarily include the particular feature, structure, or characteristic. Moreover, such phrases are not necessarily referring to the same embodiment. Further, when a particular feature, structure, or characteristic is described in connection with an embodiment, it is within the knowledge of one skilled in the art with the benefit of the present disclosure to affect such feature, structure, or characteristic in connection with other embodiments whether or not explicitly described. After reading the description, it
will be apparent to one skilled in the relevant art(s) how to implement the disclosure in alternative embodiments.
[0050] Furthermore, no element, component, or method step in the present disclosure is intended to be dedicated to the public regardless of whether the element, component, or method step is explicitly recited in the claims. No claim element herein is to be construed under the provisions of 35 U.S.C. § 1 12(f), unless the element is expressly recited using the phrase "means for." As used herein, the terms "comprises," "comprising," or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus.
Claims
1 . A system for providing a preemptive, pre-contemplation prescriber warnings
comprising:
a storage medium for at least one patient health record;
a first computing device capable of receiving the at least one patient health record; and
software, wherein the software is configured to provide a preemptive, pre- contemplation warning to a prescriber when an available treatment plan could negatively impact a patient based on the patient health record.
2. The system according to claim 1 , wherein the warning includes visual and audio alerts.
3. The system according to claim 1 , wherein the warning is provided within an order set.
4. A method for providing preemptive, pre-contemplation warnings comprising: receiving a patient health record;
comparing the patient health record to available medical ordering options to determine potential negative effects of the options to the patient; and
providing a preemptive, pre-contemplation warning to a provider of the potential negative effects.
5. The method of claim 4, wherein the medical ordering options are treatment
options.
6. The method of claim 4, wherein the medical ordering options include diagnostic radiology.
7. The method of claim 4, wherein the provider is a prescriber.
8. A system for providing a preemptive, pre-contemplation prescriber warnings comprising:
a storage medium for at least one patient health record;
a first computing device capable of receiving the at least one patient health record; and
software, wherein the software is configured to provide a preemptive, pre- contemplation notification to a provider when an available medical order could negatively impact a patient.
9. The system of claim 8, wherein the preemptive, pre-contemplation notification is provided to the provider when the available medical order could negatively impact a patient based on a patient health record.
10. The system of claim 8, wherein the medical order includes diagnostic radiology.
1 1 . The system of claim 8, wherein preemptive, pre-contemplation notification
includes formulary information.
12. The system of claim 8, wherein the preemptive, pre-contemplation notification includes cost information.
13. The system of claim 8, wherein the preemptive, pre-contemplation notification includes insurance information.
14. The system of claim 8, wherein the provider is a knowledge vendor, a physician, a pharmacist, or a nurse.
15. The system of claim 8, wherein the preemptive, pre-contemplation notification is a warning.
16. The system of claim 15, wherein the warning includes visual and audio alerts.
17. The system of claim 15, wherein the warning is provided within an order set.
18. A method for providing preemptive, pre-contemplation warnings comprising: comparing, by the system of claim 8, a patient health record to available medical ordering options to determine any potential negative effects of the options to the patient; and
providing, by the system of claim 8, a preemptive, pre-contemplation warning to a provider of the potential negative effects.
19. The method of claim 18, wherein the medical ordering options are treatment options.
20. The method of claim 18, wherein the medical ordering options include diagnostic radiology.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US201462079420P | 2014-11-13 | 2014-11-13 | |
| US62/079,420 | 2014-11-13 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| WO2016077697A1 true WO2016077697A1 (en) | 2016-05-19 |
Family
ID=55955106
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| PCT/US2015/060582 WO2016077697A1 (en) | 2014-11-13 | 2015-11-13 | Preemptive drug interaction and drug allergy alerts |
Country Status (1)
| Country | Link |
|---|---|
| WO (1) | WO2016077697A1 (en) |
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| US20180190144A1 (en) * | 2017-01-04 | 2018-07-05 | International Business Machines Corporation | System and method for cognitive intervention on human interactions |
| CN109841268A (en) * | 2019-01-18 | 2019-06-04 | 杭州逸曜信息技术有限公司 | A kind of processing method of allergy information |
| US10318639B2 (en) | 2017-02-03 | 2019-06-11 | International Business Machines Corporation | Intelligent action recommendation |
| US10373515B2 (en) | 2017-01-04 | 2019-08-06 | International Business Machines Corporation | System and method for cognitive intervention on human interactions |
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| US20130138450A1 (en) * | 2011-05-27 | 2013-05-30 | Alexandre Vigneux | Digital health care environment for implementing and monitoring patient health care for chronic diseases through configurable and interactive tasks |
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| US20180190144A1 (en) * | 2017-01-04 | 2018-07-05 | International Business Machines Corporation | System and method for cognitive intervention on human interactions |
| US10235990B2 (en) * | 2017-01-04 | 2019-03-19 | International Business Machines Corporation | System and method for cognitive intervention on human interactions |
| US10373515B2 (en) | 2017-01-04 | 2019-08-06 | International Business Machines Corporation | System and method for cognitive intervention on human interactions |
| US10902842B2 (en) | 2017-01-04 | 2021-01-26 | International Business Machines Corporation | System and method for cognitive intervention on human interactions |
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