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The Medication Minefield: Using Computerized Decision Support Systems to Reduce Preventable Adverse Drug Events and Hospitalizations

Bernstein, Richard MD; Kogan, Polina PharmD; Collins, Arlen MD

Journal of Ambulatory Care Management: July/September 2014 - Volume 37 - Issue 3 - p 226–240
doi: 10.1097/JAC.0000000000000033
Original Articles

Preventable adverse drug events (ADEs) are a source of avoidable hospitalizations, morbidity and mortality, especially among those older than 65 years. Computerized decision support systems (CDSSs) can identify and address ADEs, but relatively little has been written about the effectiveness of such system in the community setting. This article will review some important studies on the causes of medication-related admissions in the ambulatory setting, where a lack of communication among prescribers creates a virtual minefield of medication risk. Some preliminary data will show how the application of CDSSs can affect the outcomes of care, including a reduction in preventable admissions and readmissions.

Icahn School of Medicine at Mount Sinai, New York, New York (Dr Bernstein). Visiting Nurse Service of New York, New York (Dr. Kogan). REMEDIA, LLC, Amherst, Massachusetts (Dr. Collins).

Correspondence: Richard Bernstein, MD, Icahn School of Medicine at Mount Sinai, New York, NY 10029 (

Besides Dr. Collins, who is President and Chief Science Officer of REMEDIA, the authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins