Entscheidungsunterstützung beim Medikamentenprozess: Wie umfangreich sind die hospINDEX - Stammdaten?

Abstract

Decision-making support for the drug-order process: How comprehensive is the hospINDEX database? Systems for computerized physician order entry (CPOE) are increasingly enhanced by clinical decision support (CDS) functions in order to reduce errors in the medication delivery process. Therefore, up-to-date and quality-approved drug knowledge databases must be available, including data that is semantically structured and coded in machine-readable form. We analyzed the coverage of the CDS data from a commercially available database (hospINDEX) relative to the drugs administered to inpatients at the University Hospital in Zurich (USZ). The most comprehensive data retrieved was related to allergies and incompatibilities, pregnancy and lactation, as well as maximal doses and alerts in the context of renal and hepatic insufficiency, resulting in a coverage of 31.3% for drug orders and 45.3% for drug administrations. Lower coverage was observed for nutrition interactions, dosage adaption for renal insufficiency, and links to doping lists. Data provided on drug-drug-interactions was quite comprehensive; yet owing to its limited specificity, this functionality was primarily used by consulting pharmacologists, but only infrequently by prescribing physicians. The availability of comprehensive, machine-readable CDS data is gaining increasing relevance in advanced and quality-controlled health care services. There is thus room for improvement in Swiss drug knowledge databases, with data for selected functions only available for approximately half of the administered drugs.