Figure 4. . Representative interruptive clinical decision support alert for clopidogrel-CYP2C19 at UCHealth.

The clinical decision support alert notifies a prescribing clinician when they order clopidogrel in the inpatient setting for a patient who is a genetically mediated CYP2C19 intermediate or poor metabolizer and has had a documented percutaneous coronary intervention within the past year. In this example, the patient is a CYP2C19 poor metabolizer (*2/*2 genotype). The clinical decision support alert provides an actionable recommendation to change the medication order, displays pertinent information to endorse the recommendation (e.g., link to references), and provides acknowledge reason options if the clinician chooses not to follow the recommendation.

BMT: Bone marrow transplant; CPIC: Clinical Pharmacogenetics Implementation Consortium.