Transcript E-prescribe - Personal.psu.edu

By
Sandra Herr, RN
 -electronically
generated prescription
 -ability to utilize EMR (electronic medical
record)
 -accurate, error-free and understandable
 -improving the quality of patient care
 -reducing medication errors
 -use of palm pilot or computer
 -patient
safety
 -renew prescriptions
 -time management
 -accurate medication reconciliations
 -recognize drug interactions
 -more interaction with patients

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
-time saving
-integrated EMR
-fast
-legible
-expensive software
-limited usage
-extensive training
-complexity
(Kilbridge and Gladysheva 2001)
Hardware in E-prescibing
- PC with internet access
- DSL or Cable Modem
- Palm Pilot
- Two way internet linkage
-
-
transceiver
connects a computer to a fax or phone line
high speed internet access
ability to use a phone while e-prescribing
can use exisiting phone line connection
-
All scripts
 - Dr. First
 - MedPlus, Inc
 - Surescripts
 - ZixCorp
 - RxNT
 - Prematics
 - Misys eScript
(AMCP.org)
-
used daily in all 50 states
 - merger of RxHub / Surescripts
 - formed with CVS Caremark Corp, Express
Scripts Inc and MedCo Health Solutions, Inc
 - connects over 10,000 pharmacies
nationwide
-
-
user centered design and focus
ongoing education
simplicity
safe
secure
fast
Reflect on any experiences you may
have had recently…thoughts?
-Patient centered
-Integrated health care
-Comprehensive
Used By:
Functions:
-Physicians and nurses
-Billing/financial
-Accurate Medication
Reconciliation
-Administration
-Documentation
-Clinics
-Billing
-Pharmacy
-Continuity of Care
-Laboratory
-Discharge planning
-Radiology
-Patient centered care
-Clergy (hospital based)
-Error reduction
-Social Service
-Increased patient safety
-Spiritual/social
MAINFRAME
-interface between hardware and user
-sharing of resources
-simplifies development of applications
-multitasking system
-saves data to memory
-shared data
Data Standards:
-Healthcare level 7(HL7)
-American Society for Testing
and Material
-Healthcare Informatics
Standards Planning Panel
-Workgroups for Electronic Data
Exchange
-American National Standards
Institute (ANSI)
(Goedert 2006)
Disease/Procedure
Classification System(s):
-International Statistical and
Classification of Diseases and
Related Health Problems
(ICD-9 or ICD-10)
-Systematized Nomenclature of
Medicine (SNOMED)
(Devine, Hansen, Hollingworth,
Sullivan 2007)
 -patient
safety
 -decrease in medication errors
 -continuity of care
 -team collaboration
 -time saving
 -cost effective
 -patient centered
HIGHLY RECOMMEND EMR AND E-PRESCRIBE
FUTURE OF HEALTHCARE
A HEATHCARE WAVE FOR THE FUTURE

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Prevents medication prescription
errors
Eliminates illegible prescriptions
Provides for real-time
communications between doctors,
pharmacies and patients
Provides critical drug alerts
Patient specific information –readily
available
Provides drug pricing information
Provides payer coverage and
preferred drug information
Complete patient medication history
Reduces fraud and crime
Increases health care professional
work efficiency and reduces
administrative costs
Speedy refills
(Aspen, Wolcott, Bootman, Cronenwett,
1996)
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Lack of integration with patient
record
Likelihood that it will be replaced when
EMR is adopted
Reduced staff time spent on refill
process
Lack of integration with patient record
Initial cost to implement
Implementation and extensive training
of staff
Educational costs to train staff
Need for extensive training time for all
staff and outside vendors
Unwillingness of staff compliance and/or
acceptance to change
Selection based on criteria and need
Development of an integration system
with outside vendors and pharmacies
(Bizzarro, 2009)
-potential revenue sources from
partnering with device vendors
-objective outcome by E-prescribing
vendors
-vendors ties to the pharmaceutical
industry
- Will HIPAA regulations limit what can
be done with data
-registered
nurse
-computer skills
-informatics knowledge
-informatics skills
 -education
and training
 -mentoring for new/seasoned staff
 -super user in EMR (electronic medical
record)
 -community liaison for pharmacy and
physician practices
 -accessibility to staff
 -continued research and
education

California Health Care Foundation. (2001). Retrieved
September 17th, 2009 from
http://quality.chcf.org/documents/hospitals/EPrescribing.pdf

U.S. Department of Health & Human Services (2009).
Retrieved September 18th, 2009 from
http://www.cms.hhs.gov/eprescribing/
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Centers for Medicare and Medicaid Services (2008). Retrieved
September 18th, 2009 from
http://www.medicare.gov/Publications/Pubs/pdf/11382.pdf

- FREE electronic prescribing…for every physician in America. (2008). Retrieved
October 9th, 2009 from http://www.nationalerx.com

Bringing high-speed e-medicine to Pa. physicians. (2008). Retrieved October 8th,
2009 from http://www.physiciansnews.com/spotlight/808pa.html

Dermatology Online Journal Volume 7 Number 1. (2001). Retrieved October 11th,
2009 from
http://dermatology.cdlib.org/DOJvol7num1/media_review/ephysician/goldblum.ht
ml

Surescripts. (2009). Retrieved October 11th, 2009 from
http://www.surescripts.net/the-company.html
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Indiana University – University Technology Services (2005-2009). Retrieved October
11th, 2009 from http://kb.iu.edu/data/ajfr.html

-Electronic Health Record . (2009). Retrieved October 29th, 2009 from
http://en.wikipedia.org/wiki/Electronic_health_record

-Operating Systems. (2009). Retrieved October 29th, 2009 from
http://en.wikipedia.org/wiki/Operating_system

-The Evolution of EMR Standards. (2006). Retrieved October 30th, 2009
from http://www.healthdatamanagement.com/issues/20060501/133541.html

- Implementing an Ambulatory e-Prescribing System: Strategies Employed
and Lessons Learned to Minimize Unintended Consequences . (2007).
Retrieved from
http://www.ahrq.gov/downloads/pub/advances2/vol4/AdvancesDevine_83.pdf

Guideposts to the Future—An Agenda for Nursing Informatics. (2007). Retrieved
November 19th, 2009 from http://www.jamia.org/cgi/content/abstract/14/1/.

e-Prescribing Technology: Issues and Policy Implications in a Dynamic Market. (2001).
Retrieved November 20th, 2009 from

http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102273470.html.

Integrating evidence into clinical information systems for nursing decision
support. (2007). Retrieved November 21st, 2009 from
http://www.ijmijournal.com/article/S1386-5056(07)00162-1/abstract.

AMA announces partnership with e-prescribing vendor. (2009). Retrieved
November 22nd, 2009 from http://www.amaassn.org/amednews/2009/07/27/bisd0730.htm

Preventing Medication Errors: Quality Chasm Series. (1996). Retrieved November
22nd, 2009 from http://www.nap.edu/catalog.php?record_id=11623

e-Prescribing Briefing Managed Care Pharmacy 101 New York Health Plan
Association (2009). Retrieved November 22nd, 2009 from www.hixny.org .