Prevent opioid medication errors using instant electronic warnings
Prevent opioid medication errors using instant electronic warnings
Program built into CPOE
New York Hospital Queens in Flushing, NY, adopted an electronic order entry system around the same time it implemented an electronic medication management and tracking program.
Together, the electronic systems have made it fast and easy to track prescriptions and prevent potential problems in real time.
"We have a completely electronic ordering process for medications," says Alex Melchert, MS, RPh, director of pharmacy.
The information obtained through the medication management system can be put into the computerized physician order entry (CPOE) system along with instant warnings, he explains.
For instance, dosage ranges for opioids are in the system and will create warnings when a prescription is made for outside the range.
"We also look at drug interactions, and if we see a potential problem with a particular population, we can put in a warning screen about it," Melchert says.
"Every dose is checked individually anyway," he explains. "But if we can get it to the doctor before they write the order and actually use it as part of their thinking process then we've succeeded in changing the process."
These electronic communications serve to educate physicians at the point of order entry, Melchert says.
"So when a physician orders a product, a warning will come up and say, 'There's a potential look-alike, sound-alike medication here, are you sure this is what you really want?'" Melchert says.
A clinical pharmacist with a background in informatics creates the warning messages, which are then put into the system by an information technology specialist.
"We're lucky to have a pharmacist with a background in informatics because this is something pharmacy schools are not addressing well," Melchert says. "This is where we have to go in the industry."
Increasing numbers of hospital pharmacies are using computerization or robotics, so hospitals need to have people who know how to take that information and manipulate it, he adds.
"A new system may solve some errors, but create others, so you have to be on top of that," he says.
The CPOE system also can serve as a useful educational tool, Melchert notes.
"I use it to let people know I have a drug shortage and this is what their alternative is," he says. "The number of phone calls it saves us is phenomenal."
Physicians now ask the pharmacy department about adjusting the CPOE system to improve their workflow.
"We try to use the system in a way to reduce the number of phone calls needed and to put out information and to restrict drugs," Melchert says.
"Prescribing some drugs requires a level of confidence that the average resident hasn't developed," he explains. "So they may pick a medication because they're not sure what they really want, but then a message will come up that says they need approval for that choice."
New York Hospital Queens in Flushing, NY, adopted an electronic order entry system around the same time it implemented an electronic medication management and tracking program.Subscribe Now for Access
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