[MT-L] Dr First Smart Strings for AOM/RXM

[Jason Schumacher]

I am hearing more and more about Dr First Smart Strings for AOM/RXM for the Ambulatory prescribing of medications.  Does anyone have experience with these Dr First Smart Strings.  I just want to get the input from someone who is using the system.  Seems almost too good to be true.  Custom built order strings update monthly by Dr First.

 

Please give me any input you have.  Thanks so much everyone

 

Jason Schumacher

Clinical Informatics Pharmacist

Lima Memorial Health Systems

[Joel Sanford]

We could never get them to give us a presentation or anything else for
6.x...Not sure if anything has changed but I believe I remember a post
on here from a few months ago about the smart strings all having "1 tab"
for doses, which is awful for the admitting physician and inpt
pharmacist if you are doing electronic med rec. I guess if you have the
strength in the name fields of all your AOM meds it might work?...

Joel

--
Joel Sanford, PharmD
IT Pharmacist
Androscoggin Valley Hospital
Berlin, NH 03570
603.326.5612
joel.s...@avhnh.org

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[George W. Carrico]

And they can't be edited in any way.
You can enable or disable them but that is it.
Awful.

George Carrico, RPh
Clinical Pharmacist/IT Specialist
Paradise Valley Hospital
gwca...@primehealthcare.com

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[Charles Downs]

That sounds like a show-stopper there.
Charlie

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[Lisa Wagoner]

Let me just say I hate having to purchase a product I can't test out first (or have a demo where I could review the functionality)...and this is what Dr First is asking you to do...BUT we did decide to purchase them,. Reason - because we are going through a FULL RXM expunge in preparation for eRx and thought this would at least help somewhat with the re-build. (BTW - expunge was the best thing we ever did minus loosing our work)...

This is the information I wish I knew while making the decision (we are MG 5.66):

1) As others have stated, you can't edit them, you can only go in and suppress them if you don't like how they are built (directions, dose, QTY, refills, etc). There are some I don't like but not too many.

2) The doses are built as either 1 tab or cap. BUT there is a DTS (MG PHA 12783 or CS PHA 11909) that allows form to equal strength...so the user selects the 1 tab order string in the Med Rec and it crosses over as an inpatient med with the correct mg. The strength does not have to be part of the drug name...when a user looks up a med in the Update Med List, it shows both the Name and Strength...then the user selects the 1 tab order string. I was nervous about this one but it works perfectly.

3) Before the expunge, we had over 3,000 order strings built and Dr First wasn't able to tell us how many of theirs would duplicate what we already had built (since we knew we would have to suppress the Dr First dups). But now that we decided to do full expunge instead of a partial, we can load their order strings first (there are about 4,000) and then we will simply build any that we had defined that were not included on their list. (after the load, you can create a report to see all of the strings they loaded to compare)

4) Not updated monthly. They told us we would probably only get 1-2 updates per year.

5) The strings flip the drugs they are attach to as COMMON. We don't like this feature since we have only our RXM drugs mapped to formulary drugs flipped to Common so they are easy to identify (i.e. drugs which will easily convert to an inpatient med)...and if the med isn't under Common, we have it set to autoscroll to ALL. So, this will be a manual cleanup for us. This to me should be a user preference and is a big negative.

6) My BIGGEST issue was in the mapping. To be able to utilize the Dr First PRN order strings you have to be utilizing PRN-specific directions. In other words, to map their QID PRN  strings, you would have to have built in your Directions Dict QIDPRN with the "Default Schedule for Meds" set to PRN. We DON'T! In Meditech, the order could have the frequency of "QIDPRN" yet the user can select or change the PRN field to "No". I will say at one point we did utilize these type of directions in Med Rec prior to our 5.66 upgrade...but we had med errors because of it. Therefore, we stopped using PRN-specific frequencies since we felt this is a patient safety issue due to the potential for conflicting information within the order. When I raised this point to Dr First (the PRN field should be what determines the order as PRN, not the frequency) they said Meditech is working on a fix...but according to Meditech, it isn't ready yet. So we just won't be loading the Dr First PRN order strings (if you don't map it, they won't load; there are about 250 PRN order strings).

IMO, if we were just going to do a partial expunge and keep all of the drugs we had mapped to our formulary (and already had order strings for), I probably would not have recommended purchasing the Dr First order strings...but if you are going through a full expunge like we are, or if you do not have a lot of order strings currently built in your RXM Drug Dict,  I would recommend them.

Sorry for the long post...but again, I wish I had had this information available to me before having to make a recommendation on such an expensive purchase.

Thanks,
Lisa Wagoner, PharmD  

Pharmacy Clinical Manager/

Clinical Informatics Pharmacist
Hunt Regional Medical Center

4215 Joe Ramsey Blvd

Greenville, TX. 75401-1059
Office: 903.408.1870
Fax:    903.408.1072

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[Jeff Lee]

We are Magic 5.6 PP12. We took these strings prior to PP8. I just wanted to clarify that with proper dictionary setup and the necessary DTSs, '1 TAB' will convert properly for inpatient orders to the 'MG' strength. This allows for the outpatient therapy to more closely match what is generally used in that environment without negatively impact inpatient care.

Jeff

-----Original Message-----
From: Meditech-l [mailto:meditech-...@mtusers.com] On Behalf Of George W. Carrico

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