The Problem

90–95% of drug interaction alerts are overridden by clinicians.

Current CDS systems use static, binary lookups — if Drug A and Drug B are on the same list, an alert fires. Every time. Regardless of whether the patient is actually at risk.

5-15
drugs per ICU patient
300+
alerts per physician/day
93%
override rate

This creates alert fatigue — clinicians learn to ignore all alerts, including the rare ones that matter. The safety system becomes background noise.

How Might We

How might we make drug interaction alerts fire only when a patient is actually in danger — so that when an alert appears, clinicians trust it and act on it?

The Solution

Context-Aware CDS replaces static lookups with a dynamic risk engine that cross-references two things in real time:

What drugs

Which drugs the patient is on, how they interact, and which organ clears them

What organs

Whether that organ is actually failing — using live labs and their trend

The key insight:

1.Two nephrotoxic drugs with normal kidney function = theoretical risk only. No alert.
2.Same drugs but creatinine trending up = clearance degrading. Monitor.
3.Same drugs with GFR below 40 and rising creatinine = drugs accumulating past safe levels. Intervene now — with specific mechanism and recommended alternative.

Instead of 12 generic warnings, clinicians get 1 precise alert at exactly the moment it matters — fewer alerts, higher trust, better outcomes.