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• Yeh, Y
• Hsu, M
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Int. J. Environ. Res. Public Health 2014, 11(2), 1369-1383; doi:10.3390/ijerph110201369

Article

Detection of Potential Drug-Drug Interactions for Outpatients across Hospitals

Yu-Ting Yeh ^1,2, Min-Hui Hsu ³, Chien-Yuan Chen ⁴, Yu-Sheng Lo ³ and Chien-Tsai Liu ^3,*

¹ Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, 250 Wuhsing St., Taipei 110, Taiwan ² Information Technology Office, Shuang Ho Hospital, Taipei Medical University, 291 Zhongzheng Rd., New Taipei City 235, Taiwan ³ Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, 250 Wuhsing St., Taipei 110, Taiwan ⁴ Department of Information Management, Wan Fang Hospital, Taipei Medical University, Section 3, 111 HsingLong Rd., Taipei 116, Taiwan

* Author to whom correspondence should be addressed.

Received: 17 December 2013; in revised form: 13 January 2014 / Accepted: 14 January 2014 / Published: 27 January 2014

(This article belongs to the Special Issue Next Generation of Interoperability in Health Care: Standards and Application)

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Abstract: The National Health Insurance Administration (NHIA) has adopted smart cards (or NHI-IC cards) as health cards to carry patients’ medication histories across hospitals in Taiwan. The aims of this study are to enhance a computerized physician order entry system to support drug-drug interaction (DDI) checking based on a patient’s medication history stored in his/her NHI-IC card. For performance evaluation, we developed a transaction tracking log to keep track of every operation on NHI-IC cards. Based on analysis of the transaction tracking log from 1 August to 31 October 2007, physicians read patients’ NHI-IC cards in 71.01% (8,246) of patient visits; 33.02% (2,723) of the card reads showed at least one medicine currently being taken by the patient, 82.94% of which were prescribed during the last visit. Among 10,036 issued prescriptions, seven prescriptions (0.09%) contained at least one drug item that might interact with the currently-taken medicines stored in NHI-IC cards and triggered pop-up alerts. This study showed that the capacity of an NHI-IC card is adequate to support DDI checking across hospitals. Thus, the enhanced computerized physician order entry (CPOE) system can support better DDI checking when physicians are making prescriptions and provide safer medication care, particularly for patients who receive medication care from different hospitals.

Keywords: drug-drug interactions; health smart cards; CPOE system; system interoperability; patient safety

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