Medication decision support is a growing area of clinical decision support (CDS), according to Anna Dover, PharmD, director of product management for First Databank, a provider of drug and medical device databanks based in San Bruno, CA.

She offers these tips for making the best use of CDS without inadvertently creating a burden for clinicians:

Make alerts actionable. Fit the medication decision support into the user’s workflow without interrupting them.

Move alerts to the time when they are relevant and to the best person capable of understanding and making a decision about the risk or medication.

Use decision support that incorporates patient characteristics.

“We are going to see that alerts and decision support that rely only on medication lists and nothing more specific from the patient will start to fade away,” Dover says. “That traditional approach, although very sensitive, is not very specific. In other words, the alert was good at telling you about a potential risk, but not good about telling you whether this specific patient was at higher or lower risk.”

Use the technical capability to leverage lab results, patient age, gender, diagnosis, and other factors to fire an alert when the risk is high, or automatically suppress an alert when the risk is low. It is important to use this type of technology to improve care while alleviating clinician frustration.

Leverage analytics for better medication decision support.

Monitoring and receiving feedback is essential for effective decision support. “By looking at the data being generated through prescribing, we can evaluate how providers interact with alerts and optimize as needed. Analytics can also help make predictions about how a clinician or set of clinicians will respond to alert-tuning or modification,” Dover says. “It’s possible to use analytics to simulate and make educated guesses about whether an alert will have the intended effect and improve care, or whether it will cause additional burden to the prescriber.”

Monitor the effects of deployments, gather feedback, and respond to optimize. It is important to closely manage and maintain knowledge of the CDS to reflect evidence and pivot as needed.


  • Anna Dover, PharmD, Director, Product Management, First Databank, San Bruno, CA. Phone: (800) 633-3453.