Comparison to current standard of care
renal/liver dysfunction
DRUG-DRUG INTERACTION
At present, the Michigan Medicine system provides alerts for inappropriate DOAC prescriptions only for new prescriptions and only for select drug-drug interactions (no alerts specific to indication or renal/liver dysfunction). Furthermore, the currently existing alerts do not guide corrective actions. At minimum, our new system will improve upon this by (1) offering enhanced alerts that provide prescribers with additional information on the source of the inappropriate prescription and have been informed by a user-centered design process, and (2) adding existing prescription notifications that ensure that one or more medical professionals are notified when changes in patient characteristics affect the current DOAC prescription appropriateness.To further ensure patient safety, study investigators have also created a safety review mechanism that will review any un-addressed unsafe DOAC prescribing to ensure that patients are not unnecessarily harmed. This will include a review of any non-evidence-based DOAC prescription at 14 business days following either an alert or notification.