A novel personalized fall risk calculator: A prototype for improving the safety of prescribing through computerized decision support

Abstract

It is widely accepted that electronic prescribing and integrated drug information systems can reduce avoidable errors in prescribing and dispensing. An optimal system that both enhances the uptake by clinicians and improves the safety of prescribing would have features and functionality that includes the integration of patient demographic information, retrieval of all currently active drugs, automated alerts for relevant prescribing problems, integration of electronic prescriptions and drug discontinuation orders into pharmacy systems, and monitoring of patient adherence. Targeted alerts about the overuse of psychotropic drugs in the elderly would be particularly relevant since this situation represents a potentially preventable cause of injuries. This chapter describes the results of a cluster randomized trial using a cutting-edge custom-designed computer-assisted alert for the detection and management of psychotropic drug use. The results showed that physicians who were exposed to the personalized patient alerts were more likely to reduce drugs that were shown to contribute to fall risk, with greater changes occurring when greater risk was displayed. These positive findings are promising, since prescribers will do the right thing when given the information in an easily understandable format. Computerized decision support is a powerful tool to deliver value-added information to consumers and clinicians at the point of care. The next steps involve establishing the standards for delivering evidence into practice, determining what data is needed for personalized predictions, and determining how to deploy decision- support systems across multiple platforms.