Relevant signals

Alert fatigue

In hospital pharmacies, medication safety is preserved with the aid of so-called hospital pharmacy information systems (HPIS). Every day, these systems generate a multitude of warning signals, but not all of these signals are relevant.

Research shows that only about 1,5% of the signals that are generated require the hospital pharmacist to take action. This profusion of unnecessary signals causes alert fatigue, which is why important signals are sometimes ignored erroneously.

For example, when metformine is prescribed, this is (a part of) what the HPIS generates:

“In case of a creatinine clearance of 30-50 ml/min: reduce start dosage to 2x 500 mg per day, in case of a creatinine clearance of 10-30 ml/min: metformine is contra-indicated, in case of a creatinine clearance of less than 10 ml/min: unable to make general recommendation.”

Pharmaps Medication Safety PLUS retrieves the patient's lab result for creatinine clearance from the laboratory system and combines this with the appropriate recommendation, or omits the signal if the clearance value is –in this specific case– greater than 50 ml/min.

Automated monitoring system

(Hospital) Pharmacists acknowledge the problem that irrelevant warning signals pose. They would greatly benefit from switching to an integrated automated system.

Pharmaps Medication Safety PLUS improves the process for the pharmacist by integrating systems and generating only relevant warning signals. In many cases this relevance depends on the clinical-chemical parameters of the patient. By combining these parameters with the prescription medication, the application presents only signals that are relevant for the patient.

Result examples from practice

HPIS G-standard versus Pharmaps G-standard incl. Clinical Rules (INR, Harm Wrestling, renal function, etc.) results in better score for Pharmaps.
The category relevant will be larger than 55% in the Pharmaps release at the end of 2010 because of continuous fine-tuning.
Absolute number of displayed messages is 2622 HPIS against 2256 Pharmaps.