Fireside Chat: Caroline Prouse on Targeted Medication Warnings

Hi Caroline – can you tell us what are Targeted Medication warnings (TMWs)?

Yes of course. In today’s EPMA and EPR systems, potential prescribing errors and advice are presented to the clinician via warnings when prescribing medication. This is the established method of interrupting the prescribing workflow to prevent potential patient harm from occurring but does not give an advised action.

Targeted Medication Warnings are the next generation of electronic prescribing decision support, as they focus on the potential clinical consequences of a prescribing event for a particular patient rather than just the medications in isolation. By giving a prompt associated with the action, this approach provides more patient-specific guidance to the clinician within the Targeted Medication Warning shown on screen. Using this functionality, the clinician can accept or reject that suggested action within the Clinical Decision Support (CDS) guidance shown on screen and complete the prescription. The potential solution will save the clinician valuable time in avoiding repeated steps in the prescribing workflow, and - from an experience point of view - the clinician will see a significant reduction in alerts shown on screen within any prescribing event due to the patient specificity.

Can you tell us a bit about the work you are doing on Targeted Medication Warnings?

We are working with the US FDB product team to inform the development approach and to collaborate on content development priorities, as well as the structure of the technical architecture of this solution and how this can be applied to the UK market.

The US FDB team have already carried out an analysis of the potential impact of this solution for clinical users. They found that TMW achieves a 70% reduction in Hyperkalaemia alerts generated to the user. This is due to the increased patient information utilised within the prescribing solution and improved contextual design in comparison to the historical medication-led approach. The team here in the UK are carrying out an analysis of UK clinical prescribing data to validate the approach and capability of the solution, which is based on UK clinical practices.

Can you talk us through the potential benefits of Targeted Medication warnings?

 Yes of course, there are lots of them! 

• The solution will provide more actionable warnings that can be implemented in the vendor’s workflow – improving the clinical user’s experience.   
• The clinician will see a significant reduction in alerts presented within the workflow – with the potential of up to 70% reduction in alerts shown with the focus on clinical consequences rather than medications.
• The prescribing support provided will be able to utilise additional input data available within the PMR i.e. more patient data, and latest lab results – giving a more patient-specific output.
• The clinician will have more relevant alerts shown to them within this workflow, which are refined patient and medication specific alerts.
• The solution will enable greater flexibility for future patient-specific and other data attributes to be added to inform prescribing.
• The solution will enable FDB to deliver patient-specific modules / services providing not only core CDS support, but additional clinical modules that meet the needs of the specific clinical setting.
• The solution will tackle alert fatigue and improve actionable warnings that are shown to a user.

That sounds really interesting, what are you planning to do going forward?

We have plans to engage UK clinical stakeholders to help us better understand the potential impacts of the solution for patient safety and clinical user experience, both in comparison to the established clinical workflows in place today, as well as identifying other value benefits of this type of solution.

If any of our customers (end user Trusts) are interested in being involved, please do get in touch to learn more about the work being carried out, by contacting Caroline directly. 
We plan to ensure that the solution available to our customers will be FHIR enabled and fully interoperable and compliant to the national coding standards.  

Can you tell us any timelines?

 We are just starting on testing the data feasibility and we are aiming to run a prototype of the solution with NHS settings in 2025. 
  
Sounds really interesting - what should clients do if they are interested in finding out more?

Contact Caroline, product manager for Multilex to find out more.

Thank you!