Medication Review Software for Alerts and Pharmacist Workload
Drug pairs grow faster than medication lists, so interaction alerts and pharmacist review queues grow fastest for patients on many medications. Agnotic Technologies builds medication review software to your requirements.
Last reviewed by the Agnotic Technologies engineering team
Why does medication review workload grow so fast?
Medication review workload grows fast because interaction screening compares every medication with every other one: a patient on n medications has n x (n minus 1) / 2 drug pairs. Agnotic Technologies builds medication review software that screens those pairs, tiers the alerts and routes the ones that need a pharmacist into a tracked review queue.
Which medication review problems does this solve?
Screening volume, alert volume and pharmacist time all rise with the length of the medication list.
Pairs grow faster than lists
Each new medication is checked against every existing one, so a list of 10 medications already has 45 pairs to screen.
Alert fatigue
When many screened pairs fire an alert, prescribers and pharmacists see more alerts than they can act on, and the important ones are harder to spot.
Pharmacist queues nobody owns
Alerts routed to a pharmacist pile up when the queue has no assignment or due times, and reviews not cleared the same day carry over.
Alerts that are not drug pairs
Drug-condition, drug-allergy and duplicate-therapy alerts are not pairs of medications, so they need their own rules and counts.
Knowledge base differences
Two interaction databases can flag different pairs for the same list, so alert volume changes when the knowledge base changes.
No record of review decisions
Without a stored record of each issue and how it was resolved, reviews cannot be counted, assigned or audited.
What do we build for medication review?
Agnotic Technologies builds medication review software to your requirements: your EHR, your licensed interaction knowledge base, your routing rules and your staffing.
Interaction screening service
A service that screens every medication pair against your licensed interaction knowledge base at order, refill or review.
CDS Hooks integration
Order-select and order-sign hooks that return interaction cards inside the EHR workflow, where the EHR supports CDS Hooks.
Severity tiering and duplicate suppression
Rules that tier alerts by severity, suppress duplicates already acknowledged and decide which alerts reach a pharmacist.
Pharmacist review queue
A worklist with assignment, due times and carry-over handling, so routed reviews are cleared or escalated.
Issues stored as FHIR DetectedIssue
Each screening result stored with its severity and resolution, so reviews can be counted, assigned and audited like any other work item.
Medication therapy management workflows
Comprehensive and targeted medication review workflows with written summaries, for Medicare Part D medication therapy management programs.
Audit and workload reporting
Reports on alerts, overrides, review times and queue size by site and pharmacist.
Why do drug pairs grow faster than the medication list?
Interaction screening compares every medication with every other one. The newest medication is checked against all the existing ones, so a list of n medications gains n new pairs when one more is added.
| Active medications | Pairs to screen | Pairs added by the last medication |
|---|---|---|
| 2 | 1 | 1 |
| 3 | 3 | 2 |
| 5 | 10 | 4 |
| 8 | 28 | 7 |
| 10 | 45 | 9 |
| 15 | 105 | 14 |
What does each volume size in the system?
Ways to cut alert volume, such as severity tiering and duplicate suppression, are covered on our medication management software and clinical decision support pages.
- Pairs screened: the calls your interaction checking service handles.
- Alerts: the volume your alert display, logging and reporting must hold.
- Routed reviews per working day: the pharmacist queue, how it splits across staff and what happens when it is not cleared the same day.
- Pharmacist hours: whether the queue fits the hours you have.
- Longer lists: how sensitive the queue is when every patient adds one more medication.
Where do interaction alerts come from in an EHR?
In an EHR that supports CDS Hooks, an interaction check can run when a clinician selects or signs an order, and the external service answers with cards shown in the workflow.
A screening result can be stored as a FHIR DetectedIssue with a severity of high, moderate or low. Storing it that way lets routed reviews be counted, assigned and audited like any other work item.
Checks outside pair screening
- Drug-condition, drug-allergy and duplicate-therapy alerts. They are not pairs of medications, so they need their own count.
- The severity mix. A queue of low-severity alerts and a queue of high-severity ones need different routing.
- Knowledge base differences. Two interaction databases can flag different pairs for the same list, so an alert rate belongs to the knowledge base it was measured on.
- Dose, route and timing checks that some systems run alongside pair screening.
- Whether an alert is clinically right. Software counts and routes the work; the judgment stays with the pharmacist and prescriber.
Which rules and standards shape medication review software?
Short facts we design medication review workflows around, each linked to its primary source.
Medicare Part D medication therapy management programs must offer an annual comprehensive medication review with written summaries, including an interactive consultation by a pharmacist or other qualified provider, and quarterly targeted medication reviews.
Source: 42 CFR 423.153(d) (eCFR)CDS Hooks 2.0 lists order-select and order-sign among its hooks, the points where an EHR can call an external decision support service, and marks the older medication-prescribe hook as deprecated.
Source: HL7 CDS Hooks 2.0FHIR R4 DetectedIssue records an actual or potential clinical issue with or between active or proposed clinical actions for a patient, such as a drug-drug interaction, with a severity of high, moderate or low.
Source: HL7 FHIR R4 DetectedIssue resource
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Which standards does Agnotic build healthcare software against?
HIPAA
Health Insurance Portability and Accountability Act
Protect PHI with privacy-first architecture, encrypted storage and transmission, strict access controls, and traceable audit logs.
GDPR
General Data Protection Regulation
Implement lawful consent flows, data minimization, retention controls, and secure processing for sensitive health data.
FHIR
Fast Healthcare Interoperability Resources
Enable standardized health data exchange across apps, care teams, and systems through standards-based FHIR APIs.
HL7
Health Level Seven International
Support enterprise-grade interoperability with HL7-based integrations for records, events, and clinical messaging workflows.
HITRUST
Health Information Trust Alliance
Align security programs to healthcare-specific control and risk management practices trusted by providers and ecosystem partners.
HITECH
Health Information Technology for Economic and Clinical Health Act
Design with breach notification readiness, digital record safeguards, and operational controls that support regulated care programs.
SaMD
FDA Software as a Medical Device
Plan software quality, traceability, and documentation pathways for products that may require SaMD review and submission.
MDR (EU)
Medical Device Regulation (European Union)
Prepare EU market-ready processes for risk classification, evidence tracking, and lifecycle governance under MDR expectations.
SAMHSA
Substance Abuse and Mental Health Services Administration
Apply confidentiality controls and consent-aware sharing models for behavioral and mental health data experiences.
Where should you go next?
- Medication management software developmentMedication workflows, decision support and pharmacy integration.
- Clinical decision supportRules, alert tuning and fatigue control.
- Clinical decision support AI agentDecision support delivered through CDS Hooks.
- Pharmacy management softwareDispensing, verification and pharmacist workflows.
- Surescripts e-prescribing integrationNCPDP SCRIPT, medication history and EPCS.