Addressing Gaps in Pediatric Prescribing Using Scalable and Interoperable Prescription Decision Support
Award last edited on: 11/14/2017

Sponsored Program
Awarding Agency
Total Award Amount
Award Phase
Solicitation Topic Code
Principal Investigator
Weston W Blakeslee

Company Information

RxRevu Inc

2601 Blake Street Suite 450
Denver, CO 80205
   (800) 360-4965
Location: Single
Congr. District: 01
County: Denver

Phase I

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Phase I Amount
Electronic-­prescribing is now widely adopted by US healthcare systems, but clinical functionality of e-­prescribing falls short in the realm of pediatrics. Medication prescribing is intrinsically more complex for pediatric patients due to weight-­based dosing, the lack of widely adopted medication formulation recipes, inconsistent off-­label usage of drugs, appropriate drugs for given conditions, and appropriate dose rounding percentages that will still make the drug treatment clinically useful. Clinical decision support (CDS) tools can improve shortcomings in electronic health records (EHR), yet many focus on adult only patient populations, are limited in drug and condition coverage, exist as web-­services external to the native EHR environment, and generate excessive pop-­up alerts that contribute to provider “alert-­fatigue”. Safety Through E-­Prescribing Systems Tools (STEPSTools) is a web-­service that was designed to be a comprehensive pediatric dosing knowledge dissemination platform that fills the void of condition based medication usage, expert consensus-­ based dosage rounding, and extemporaneous drug formulation recipes currently missing in EHR functionality. RxCheck is a Prescription Decision Support (PDS) platform built by RxREVU, that is surfaced directly in the provider’s native Epic EHR workflow to ensure the accuracy of information utilization by providers, drive operational best practices, surface information that may or may not natively exist in the EHR, and improve the clinical window. Hypothesis: By combining the strengths and expertise of STEPSTools pediatric prescribing technology with RxREVU’s RxCheck Prescription Decision Support platform, a comprehensive pediatric prescribing product will be developed that is scalable, interoperable, and utilized directly at the point of prescribing in order to drive consistent evidence-­based prescribing patterns for pediatricians, and improve clinical outcomes for pediatric patients. Specific Aims: By the investigators own admission, a pediatric prescribing technology will not be useful if it is not comprehensive and up-­to-­date. This proposal aims to update STEPSTools technology from 2011 pediatric prescribing standards to 2016 standards, as new evidence and innovative approaches to pediatric prescribing have occurred. Rapid and effective communication between STEPSTools, RxCheck and Vanderbilt’s Epic EHR is critical for the accuracy and safety of the prescribing module. These data handshakes will be rigorously tested for accuracy in the second aim. Provider adoption and clinical utility of an RxCheck pediatric prescribing module is critical to test the feasibility of widespread scalability of the tool. The number of times RxCheck is accessed compared to total prescriptions written, as well as provider acceptance rates of the recommendations surfaced by RxCheck in Epic will be measured and success of this Phase I SBIR proposal will be determined here.

Public Health Relevance Statement:
PROJECT NARRATIVE The primary goal of this Phase I SBIR proposal is to prove feasibility of a pediatric electronic prescribing module built in the RxCheck Prescription Decision Support platform and surfaced directly within the native electronic health record (EHR). Our solution leverages an expert-­based dosing and formulation framework developed by researchers at Vanderbilt University Medical Center. Importantly, RxCheck is HL7 compliant and fully compatible with the emerging Fast Healthcare Interoperability Resources (FHIR) standard, helping to ensure the developed prescribing framework can be easily deployed to any modern EHR supporting the emerging interoperability standards.

Project Terms:
Academic Medical Centers; Address; Admission activity; Adopted; Adoption; Adult; Age; base; Child; Childhood; Clinic; Clinical; Clinical Decision Support Systems; Clinical Practice Guideline; Clinical Protocols; Clinical Treatment; Code; commercialization; Communication; Complex; computerized; Consensus; Data; design; Development; Disease; dosage; Dose; Drug Formulations; Drug usage; Electronic Health Record; Ensure; Environment; evidence base; experience; falls; Fatigue; Feedback; Formulation; Goals; Health Insurance Portability and Accountability Act; Healthcare; Healthcare Systems; improved; innovation; interoperability; Knowledge; Label; Measures; Methods; Modernization; Morbidity - disease rate; mortality; Outcome; Outpatients; patient population; Patient-Focused Outcomes; Pattern; pediatric patients; pediatrician; Pediatrics; Pharmaceutical Preparations; Pharmacotherapy; Phase; Physicians; Plague; Provider; Recipe; Recommendation; Research; Research Personnel; Resources; Risk; Safety; Secure; Small Business Innovation Research Grant; success; support tools; Surface; Surveys; System; Technology; Testing; Time; tool; Trust; Universities; Update; Validation; Vendor; web services; Weight

Phase II

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