Using Technology to Alert Clinicians to Potential Allergy, Drug Interactions
Li Zhou, M.D., Ph.D.
Professor of Medicine, Harvard Medical School
Lead investigator, Brigham and Women’s Hospital
“I really appreciate how AHRQ looks for ways to use technology to improve patient care.”
Li Zhou, M.D., Ph.D., has found a sweet spot at the intersection of patient safety and artificial intelligence. A professor of medicine at Harvard Medical School and a lead investigator at Boston’s Brigham and Women’s Hospital, Dr. Zhou has used AHRQ funding to conduct groundbreaking patient safety research on medication reconciliation, allergy documentation, drug-allergy alerts, and natural language processing (NLP)—a branch of artificial intelligence that makes it possible for people to talk to machines.
When she started at Brigham and Women’s Hospital as a senior medical informatician, Dr. Zhou used technology to provide medical advice to clinicians based on patient data. “This led to an interest in medication-related alerts, drug-drug interactions, and drug-allergy interactions,” said Dr. Zhou. She encountered AHRQ grantee David W. Bates, M.D., M.Sc., a prominent patient safety researcher who has investigated how information technology can be used to prevent adverse drug events. Dr. Bates became a mentor and encouraged Dr. Zhou to apply for her first AHRQ grant, awarded in 2009. Her 2-year project examined how to use NLP to facilitate the use of electronic clinical texts to ensure patients’ complete medication lists are accurately recorded in their electronic health record (EHR). This helps prevent medication prescribing errors.
She received another 2-year AHRQ grant in 2012, expanding her previous research to develop an NLP-based system for medication management and reconciliation. In this project, Dr. Zhou and her team developed an innovative web-based application to identify discrepancies between patient-reported information and clinician notes about patients’ medication lists. This application was integrated with Brigham and Women’s legacy EHR before the system transitioned to Epic in 2017.
In 2013, Dr. Zhou received a 5-year AHRQ grant to use NLP to process and transmit patients’ medication allergy information in EHRs. “Drug allergy is a major type of adverse drug reaction, and it has great impact on quality of care and quality of life,” she says.
In fact, this project included more than just medication allergy information; it also included food and environmental allergy data. Dr. Zhou and her team used a system-wide allergy repository that Dr. Bates and his colleagues had developed years before as a major data source to inform the project. This grant led to two dozen published articles on related topics such as analyzing clinician override of allergy alerts and issues related to allergy documentation standards and quality.
Two more major projects followed: a 4-year AHRQ grant awarded in 2015 to explore the use of NLP to improve the accuracy and quality of dictated medical documents; and a 4-year AHRQ grant awarded in 2018 to improve allergy documentation and clinical decision support in EHR systems. In the latter project, Dr. Zhou and her team developed an allergy reconciliation module that was integrated into Brigham and Women’s EHR and piloted with more than 100 primary care physicians. This research has not yet been published.
Dr. Zhou is an associate editor for the International Journal of Medical Informatics and the Journal of General Internal Medicine and serves on the American Medical Informatics Association Board of Directors. She is an elected fellow of the American College of Medical Informatics and of the International Academy of Health Sciences Informatics.
She also has served on several AHRQ grant review committees. “AHRQ has a clear understanding of how research and technology can directly benefit patients,” she says. “As an informaticist, I really appreciate how AHRQ looks for ways to use technology to improve patient care.”
Principal Investigator: Li Zhou, M.D., Ph.D.
Institutions:Harvard Medical School, Brigham and Women’s Hospital
Grantee Since: 2009
Type of Grant: Various
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