Drug Alert Program Improves Patient Safety in an ACO

Accountable care organizations (ACOs) can leverage health information technology to improve patient safety without creating alert fatigue among providers, according to a study in the Journal of Managed Care & Specialty Pharmacy.

The authors studied the Marshfield Clinic’s Drug Safety Alert Program (DSAP), which aims to reduce adverse events by prioritizing and communicating safety issues related to medications.

The researchers found in just the first year of the DSAP, the program targeted 6 medication safety concerns involving topiramate, glyburide, simvastatin, citalopram, pioglitazone, and lovastatin. Overall, nearly 10,000 potential adverse drug events were identified and nearly 8000 were resolved by changing prescribing.

“A goal of this project was to partner with the prescriber in the overall care of the patient,” Sara Griesbach, PharmD, BCPS, BCACP, director of clinical pharmacy services at Marshfield Clinic, said in a statement. “This program was created to identify drug alerts with potential to impact a large patient population that may require intervention to decrease the risk for adverse drug events.”

The Marshfield Clinic’s DSAP is also designed to prevent alert fatigue among the ACO providers. The program sends alerts in a package that aggregates all of the patients prescribed a specific medication instead of the typical format of sending alerts on individual patients.

However, the researchers acknowledge that this process of aggregating messages to avoid inundating physicians also means these alerts are communicated in a retrospective manner. In contrast, Geisinger Health System pushes alerts to physicians in a real-time manner, which has improved outcomes.

Finally, the DSAP targets some quality measures that CMS is highlighting, such as improving the health of diabetics through appropriate hypertension management, the authors reported.

”This study highlights the critical role that health information technologies play in ensuring safe and appropriate use of medications in an ACO environment,” said NPC Executive Vice President and Chief Science Officer Robert W. Dubois, MD, PhD, who is a study co-author.