When it comes to preventing adverse drug events, some suggest that traditional evidence-based prescribing must be enhanced with "person-based" approach rooted in specific data. One Web-based technology may help do that.

[See also: E-prescribing makes huge gains]

Adverse drug events and fatalities are more likely to occur in patients who take multiple medications. The frail elderly are particularly vulnerable. Studies have shown that a high percentage of hospitalizations in the elderly are attributed to unintentional overdoses.

According to medication safety experts, this means that the patient inadvertently takes too many doses, and/or takes the proper doses but the body cannot effectively clear the drugs from the system. That could cause build-up and lead to ADEs.

[See also: Adverse incident reporting system reduces risk of error]

One New Jersey-based company has developed a cloud-based medication risk mitigation platform designed to help reduce ADEs.

Cal Knowlton, CEO and founder of Moorestown, N.J.-based CareKinesis, Inc., says its EireneRx technology, is a front-end e-prescribing module that can bolt on to any electronic medical record; when a physician prescribes using EireneRx, it gives the prescriber information about a patient and the medications they are taking.

"It allows the physicians or nurse practitioner to gain information that they can either use or not, as they are prescribing," says Knowlton. "It is dynamic, so if I change from this drug to that drug, it's a different sedative burden or a different anticholinergic burden, etc."

In addition to these two components, the e-prescribing module embodies another dozen personalized components that change as the prescriber enters a medication, or then tries a different medication.

Joseph J. Filippoli, senior vice president and chief information officer at CareKinesis, says EireneRx is also a medication management system that can include integration to a pharmacy dispensing system: "It's a hosted EMR ePrescribing platform, it's not a full EMR.

EireneRx, said Filippoli, takes away some of clinicians' the repetitive work and systematizes it.

"The bottom line is that in standard practice of medication management, there's a lot of stuff that people do with their brains and their repetitive hands and minds but in this case we can actually take what they do and automate it," said Filippoli.

The basic EireneRx product is a cloud-hosted medication management system that uses Amazon Web Services.

"We are a significant installation and we have redundant east and west landscapes with Amazon," said Filippoli. "It's very fault tolerant and we scale-up based on traffic and need and we turn up the dial on the horse power as demand grows."

EireneRx, according to Filippoli, is HIPPA-compliant, heavily secure and is a meaningful use Stage 2-certified e-prescribing module.

It presents an array of germane medication decision support factors, along with the complete medication profile and conditions, at the point-of-prescribing (as the prescription is being written).

"The PharmDs also are available real-time via secure instant messaging, to help translate or interpret the decision support feedback, when necessary," said Filippoli. "We're providing warnings, alerts, evidence and science-based personalized guidance at the point of prescribing. It hones the prescribing down to a very precise practice, before a prescription is sent to a dispensary."

George Brett, MD, medical director for LIFE Programs at Mars, Pa.-based Lutheran Senior Life, has been using EireneRx for the past two years.

"I can write a prescription faster on EireneRx than I could if I brought out Rx pad and pen," he says. "It's very user friendly and it's fast. It has great drop-down boxes so you can select your medication strength, diagnosis and where you want it sent."

Lutheran Senior Life is a Program of All-inclusive Care for the Elderly (PACE) facility that cares for the frail elderly who visit the community center several times per week. Brett said that, on average, each patient at his PACE center takes 10 to 13 medications. Brett said that medication errors have dropped off significantly as a result of EireneRx.