Evaluation of an electronic health record Drug Interaction Customization Editor (DICE).

This article focuses on the development and evaluation of the Drug Interaction Customization Editor (DICE), a prototype tool designed to enable healthcare organizations to customize drug-drug interaction (DDI) alerts within electronic health record (EHR) systems. The DICE tool allows filtering of DDI warnings based on four sections—General, Medication, Patient, and Visit—using discrete EHR data such as drug properties, patient demographics, laboratory values, and encounter types. A survey of primarily pharmacists with informatics roles found high perceived usefulness for customizing alerts by patient attributes (e.g., age, weight), laboratory values (e.g., creatinine clearance, international normalized ratio), and medication characteristics (e.g., route of administration). Respondents indicated that implementing DICE could reduce alert fatigue and override rates, though concerns were raised about the effort required to maintain such customizations. The prototype aims to serve as a template for EHR vendors and users to develop more advanced, user-friendly DDI alert filtering systems that improve clinical relevance and patient safety.