Adverse Drug Effects

The Adverse Drug Effects (ADE) Decision Support project was developed for the Veterans Administration (VA) to point medical clinicians to patients with potential to have adverse reactions occur in response to prescribed medications and laboratory tests. This tool is written completely as a Microsoft® SharePoint® project taking advantage of the SharePoint tool suite.

The ADE knowledge base is the background portion that is executed via a timer and pulls data from the Corporate Data Warehouse (CDW), which is the aggregation of data from more than 100 local medical centers, and checks the data against the latest triggers to see if any of the new data meets the threshold for marking a patient "at risk." If yes, the patient’s information and pertinent clinical data are saved to an ADE Application database SharePoint list. The appropriate clinical teams can then take action as needed via the ADE Trigger tool.

adverse drug effects concept of operation flow chart

Adverse drug effects (ADE) concept of operation

screen capture for create new trigger dialog

This graphic is a screen shot of the SharePoint page for managing a trigger.

chart of trending report

This screenshot of a trending report shows the total number of events recorded over an 18-week period.

The ADE Trigger Tool allows pharmacists to manage the at risk patient list, customize the list by a wide variety of demographic and clinical attributes, and create reports while maintaining the rules sets for determining when a patient may be at risk.

Patients are seen and treated at a local medical center. The local medical center gathers demographic and clinical information about the patient including information from the local communities (primary care doctors outside the VA, emergency room visits at local hospitals, etc.). Each evening, the data collected at the local sites are uploaded to regional servers and, early each morning, the regional server information is uploaded to a CDW. After the upload to the CDW is complete, a process is triggered in the SharePoint server to run the newly uploaded data against a set of knowledge-based rules. These analytics are run against the aggregated data from all sources to determine the potential for the patient to have an adverse reaction. A variety of reports can then be run against the data.

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Southwest Research Institute® (SwRI®), headquartered in San Antonio, Texas, is a multidisciplinary, independent, nonprofit, applied engineering and physical sciences research and development organization with 9 technical divisions.