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  1. FHIR Specification Feedback
  2. FHIR-29598

Not convinced that a web service based decision support can do better than existing DDI solutions.

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    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Potential Drug-Drug Interaction (PDDI) (FHIR)
    • 0.2.0 [deprecated]
    • Clinical Decision Support
    • Home [deprecated]
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      Added language to rationale:

      "The approach this IG suggests could be effective at reducing the number of alerts and increasing their relevance. For example, a recent study developed, validated, and tested 8 contextualized drug-drug interaction alert algorithms that used data from electronic health records data to fine-tune the alerts to a given patient. The interactions were chosen based on monthly override rates from a single large care facility. Testing on retrospective real-world data showed the potential for the eight algorithms to reduce alerts that interrupt clinician workflow by more than 50% from baseline.<sup>[4](#references)</sup>"

      4. Chou, E., Boyce, RD., Balkan, B., Rosko, S., Subbian, V., Romero, A., Hansten, P., Horn, J., Gephart, S., Malone, DC. Designing and Evaluating Contextualized Drug-Drug Interaction Algorithms. Accepted to JAMIA Open 02/26/2021. JAMIO-2020-0010.R3. PubMed ID: in process. PubMedCentral ID: In process.

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      Added language to rationale: "The approach this IG suggests could be effective at reducing the number of alerts and increasing their relevance. For example, a recent study developed, validated, and tested 8 contextualized drug-drug interaction alert algorithms that used data from electronic health records data to fine-tune the alerts to a given patient. The interactions were chosen based on monthly override rates from a single large care facility. Testing on retrospective real-world data showed the potential for the eight algorithms to reduce alerts that interrupt clinician workflow by more than 50% from baseline.<sup> [4] (#references)</sup>" 4. Chou, E., Boyce, RD., Balkan, B., Rosko, S., Subbian, V., Romero, A., Hansten, P., Horn, J., Gephart, S., Malone, DC. Designing and Evaluating Contextualized Drug-Drug Interaction Algorithms. Accepted to JAMIA Open 02/26/2021. JAMIO-2020-0010.R3. PubMed ID: in process. PubMedCentral ID: In process.
    • Howard Strasberg/Richard Boyce: 15-0-1
    • Clarification
    • Non-substantive

    Description

      The "Rationale" section doesn't really give a convincing case for why a web service based decision support could do better than existing Drug Drug Interaction solutions, especially in reducing the number of alerts, and increasing their relevance. Perhaps example scenarios which cannot be reasonably addressed by existing solutions would help elucidate? The worry here is that, this is yet another set of alerts to the provider, potentially risking alert fatigue even more.

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            michael_donnelly Michael Donnelly
            m_varghese Varghese Mathew
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