Clinical Decision Support

SK's DIS supports the two patient-specific DUR queries - Clinical Pre-Determination, Contraindication Checking as well as the query that allows you to search for DUR related to a drug or set or drugs. DUR in SK is only performed on prescriptions and not on dispense records. These queries support a number of parameters include patient, drug code, quantity, dose but most vendors only support the patient and drug code parameters so not all types of DUR is performed.

SK has mandated the Clinical Pre-Determination query for pharmacy vendors as part of the pharmacist prescriptive authority requirements.

Typically the vendors have supported local DUR queries that check against all locally recorded medications but not medications prescribed at other locations.

Perhaps this post will trigger others to contribute items to this topic.
NL’s DIS provides pharmacists with DUR alerting -a decision support tool. We also support a message called Clinical Prescription Pre-Determination Request (Conformance profile C03.05 0001) that could be used in the future by EMR. This decision has not yet been made for the provincial EMR. I am aware of one pharmacy vendor that supports it in their PMS in some jurisdictions. The DIS uses the same DUR engine for this message as used when a pharmacy sends a dispense request and DUR processing occurs and potentially returns an alert to pharmacy user.
The following message is used:
Canadian Electronic Drug (CeRx) Messaging Standard
Business View of Message Model
PORX_MT050020CA - Patient drug contraindications query
Its rationale for use is described as follows: “Allows for the retrieval of all potential contraindications based on a specific medication being introduced onto the patient's medication profile. Contraindications can't be found without specifying the medication, therefore this attribute is mandatory. This will most commonly be used by providers to test the viability of prescribing/dispensing a medication to a patient (in view of the patient's existing medication profile).”
Query parameters include patient identifiers and drug code.