Drug-allergy interaction
A significant fraction of medication errors and preventable adverse drug events are related to drug-allergy interactions (DAIs). Computerized prescribing can help prevent DAIs, but an accurate record of the patient's allergies is required. At many large healthcare organizations, the patient's allergy list may be distributed across several applications including computer physician order entry (CPOE), the outpatient medical record, pharmacy applications, and nurse charting applications. Each application may only have access to its own allergy data. Creating a single integrated allergy repository that all these applications can use is a complex and difficult undertaking. An article based on work done at Partners Healthcare in Boston describes just such a project. They present data documenting that patients have allergy data stored in multiple repositories. They describe issues encountered such as which applications should participate in the repository, whether "NKA" or "NKDA" should be used to document known absence of allergies, and which personnel should be allowed to enter allergies. The issues described in this paper may well be faced by other initiatives intended to create comprehensive allergy repositories.
References
Kuperman GJ, Marston E, Paterno M, et al. Creating an enterprise-wide allergy repository at Partners HealthCare System. AMIA Annu Symp Proc. 2003;:376-80.
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