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J Med Syst. 2016 Jan;40(1):24. doi: 10.1007/s10916-015-0398-9. Epub 2015 Nov 7.

Utilization of a Pharmacy Clinical Surveillance System for Pharmacist Alerting and Communication at a Tertiary Academic Medical Center.

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Department of Pharmacy Services, Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA.
Department of Pharmacy Services, Oregon Health and Science University, Portland, OR, USA.
Department of Pharmacy Services, Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA.


The objective of this analysis is to describe the utilization metrics of a pharmacy clinical surveillance system (PCSS) at a tertiary, academic medical center.We performed a retrospective database analysis assessing rule-based alerts (RBA), interventions and pharmacist communication notes documented in the PCSS from January 1, 2014 to December 31, 2014. Reports were generated on 92 unique RBAs sent to clinicians for evaluation. Metrics assessed included the number of RBAs that were triggered, clinically evaluated, intervened on by pharmacists, and therapeutic category of interventions. Pharmacy communication notes were also evaluated.A total of 399,979 RBAs were triggered through the PCSS. During that time, pharmacists documented a total of 17,733 interventions. The most common RBAs were related to lab abnormalities (132,487; 33 %) and anticoagulation/antiplatelet therapy (126,425; 32.1 %). Interventions were most frequently related to RBAs regarding anticoagulation/antiplatelet therapy (6412; 36 %) and antimicrobial therapy (3320; 19 %). Pharmacist communication was most commonly related to clarification of medication and lab orders, and therapeutic drug monitoring.Based on utilization metrics presented, the implementation of a PCSS has successfully generated RBAs to aid pharmacists in clinical practice and improved departmental documentation and communication. Further analysis is warranted to assess the impact of the RBAs, interventions, and communication notes on outcomes such as hospital cost and adverse drug events.


Clinical pharmacy information systems; Communication programs; Medication alert systems; Surveillance

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