Adverse drug reactions are a major source of preventable morbidity and mortality, especially among the elderly, who are both more sensitive to and are taking larger numbers of different medications. The insurance industry has recently addressed this problem through the implementation of drug interaction alerts to pharmacists in conjunction with immediate online claims adjudication for almost 60% of prescriptions (and increasing rapidly). These alerts are based on stored patient drug profiles of third party administrators (TPAs) which are updated whenever prescriptions are filled. While these alerts are very helpful, the pharmacist does not prescribe, resulting in time-consuming and costly delays to contact the physician to remedy potential interactions. We propose to address this problem by evaluating the feasibility of making the drug profile and interaction information easily available to the physician before the prescription is written. By utilizing the existing drug profiles from TPAs and initially providing information delivery to physicians by fax using touch-tone phone requests, we believe that this system can be created and operated cost-effectively. Delivering the relevant information to the point of decision should result in further decreases in adverse drug reactions, simultaneously improving the quality and decreasing the cost of medical care.
