Prescription safety
96%of medication alertsare overridden.
PMC systematic reviewEvery record system already flags interactions. Almost all of it is dismissed, because almost all of it is noise. Being ignored is the problem worth solving.
- Dismissed
- Read
- Changed the order
Illustration. The proportion comes from published override research, not from the log of any one hospital.
The problem
Four numbers, none of them ours.
Accu-Rx has no deployment and no outcome study, so nothing here measures it. Every figure below was counted by somebody else, and says who.
64.1
passive alerts per intensive care patient, per day. Only 4.5 percent are genuine emergencies.
J. Patient Safety1.3M
patients a year experiencing harm related to their medicines.
WHO, 2024$42B
estimated global annual cost of medication errors.
WHO, 2024$7.3B
estimated annual US cost of preventable adverse drug reactions.
WHO, 2024Noise
Most alerts have nothing to decide.
Every record system already matches drug pairs, and mostly gets it right. Three of the four beside this are real interactions. One leaves the prescriber something to decide.
- 01
Is there anything to do?
An interaction the prescriber cannot act on at this hour is a keystroke, not a warning.
- 02
Has the record answered it?
The dose chosen, the reason the two drugs are together, the hours between them. Most flagged pairs are answered in the chart already.
- 03
Was it asked yesterday?
The same pair at the same doses, answered on Monday. Raising it again on Tuesday teaches a prescriber to dismiss before reading.
04
Checked
01
Surfaced
03
Held back
- Surfaced
Being orderedCiprofloxacin400 mg IV q12h
Already activeTizanidine4 mg PO, day 3
WhyCiprofloxacin blocks the enzyme that clears tizanidine, and the label calls the pair contraindicated. Confirm it, or pick another antibiotic.
- Held back
Being orderedSimvastatin20 mg PO nightly
Already activeAmlodipine10 mg PO daily
Why notThe label answers this by capping the daily simvastatin dose. The order beside it is already at that cap.
- Held back
Being orderedClopidogrel75 mg PO daily
Already activeAspirin81 mg PO daily
Why notTogether they raise the bleeding risk. Here together is the treatment, written up with the stent on admission.
- Held back
Being orderedCalcium carbonate500 mg PO, 11:00
Already activeLevothyroxine100 mcg PO, 07:00
Why notThe interaction asks for four hours between the two. The chart already has them four hours apart.
Three of these four are real interactions. Real is not the same as worth an interruption.
Deployment
It runs in two places.
Checking like this is normally a module inside a hospital record system and nothing else. That leaves out every clinic without one.
In the record system
The interaction and allergy check runs inside the record system the prescriber already has open, at the moment the drug is ordered.
On its own
It also stands alone, for the clinics that have no record system and for a person checking their own medicines.
Limits
What it will not do.
A check that refuses nothing has not thought about being wrong. These four are written in the negative on purpose.
It does not decide.
The prescriber writes the order and signs it. The check is something read on the way there.
It does not read the patient.
That is a different question and a different piece of software. This one reads a prescription, not a person.
It does not replace the pharmacist.
A pharmacy review sees things a check on drug pairs never will. The two overlap. Neither one is the other.
It does not measure itself.
No deployment and no outcome study, so no number on this page is ours.
Contact
Bring your override log.
We will read a week of it with you, pair by pair: what fired, what fired twice at the same doses, and what was answered the same way every time.
Email us