[MEDITECH-L] PHARMACY VERIFICATION

[Makara, Susan]

Hi all:

We have recently started using the verification process in pharmacy to verify tech orders (previously they entered verified and we used a printed report which was used to check the order entry).

Our largest facility in the health region just started the verify process last week.   This extremely busy pharmacy uses pharmacy order sets extensively.   We have numerous order sets where we have checked off the "override interaction checking" box in the order set dictionary because we are entering meds with various routes of administration so do not need to receive the duplicate flags.

When the techs do the order entry, they do not receive these flags.    However, when the pharmacists verify the orders, the duplicates are all flagged and it is causing a huge workload for the pharmacists to have to override all these duplicate screens when they verify.

Meditech says "working as designed".    I am saying, if the flag is not there on order entry by the techs, then it should not be there when the pharmacists verify.   They should only see the flags that the technician saw during the order entry process.

Has anyone else experienced this issue and how did you handle it?   Right now the pharmacists are telling the techs, if the orders are to be entered using a multiple-med set, to simply give to the pharmacists and they will enter as it is quicker/easier than receiving all the duplicate flags.

Any thoughts around this issue would be appreciated.

Susan

Susan Makara, B.Sc.(Pharm)
Coordinator Pharmacy Information Systems 
Interior Health   2355 Acland Rd., Kelowna, B.C.  V1X 7X9
( 250-491-6756     * Susan....@interiorhealth.ca
Fax: 250-491-6710

"Information for Live: Excellence in Service, Excellence in Information, Excellence in Health"

[Charlie Downs]

Susan - Another case of " working as designed". Meditech fails to acknowledge that it is a poor design. This is one of the reasons that pharmacists enter all of our orders; it is faster than the verification process and frees up a tech. Plus, we have a fairly high turnover rate with techs, and so it eliminates a lot of extra training. We only have to train the pharmacists, they pick it up much faster, and our pharmacists staff is much more stable.

Charlie

Charles Downs Pharm.D.
Washington County Hospital
Inpatient Pharmacy
251 E. Antietam Street
Hagerstown, MD, 21740
301-790-8904

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[Thompson, Jeff]

Susan,

I’m going to respectfully disagree.  Speaking from Kansas regulations, the technician could not make the “judgmental decision” of which order is appropriate for the patient.  Granted identical orders are easy but many times they are not the same orders.  It is the pharmacists that should make these type of decisions so they should have all the warnings.   If you are in a situation where the techs are allowed to make these types of decisions, then I can see where a parameter setting would be useful.

 

Jeff Thompson

Newman Regional Health

Emporia, KS  66801

[Truax, Valerie]

Susan,

Do you mean you're being flagged for duplicates with in the Order Set or with what the patient is already on?  I would think you would want to know if the patient was already on a drug and it was going to be entered again via an order set.  If you mean it's flagging duplicates within an Order Set I can't believe that's working as designed.  I would go over the head of the consultant that told you that.  We have the 'Override Interaction Checking' set to 'Y' and it works perfectly.  We are C/S and can set the flags that your users see, and do,  within the Access dictionary.  We have always done tech order entry however, our pharmacists enter the order sets because it's faster that way.

Valerie

[sda...@uhcc.com]

We also have all orders entered by Pharmacists (or by Physicians via POM). When we went through our original Meditech PHA implementation in 1996, we investigated the possibility of using the Tech verification process, and, as Charlie says, we found it to be the equivalent of entering orders twice, so we never used it. We also use a lot of Order Sets, even for single items like PBs, but if you have a Tech enter an unverified Order Set, the process of having the Pharmacist verify it completely defeats the time-saving feature of the Order Set. In pre-Meditech times, when we were using DigiMedics, as I recall, we did have Techs enter orders, and the Pharmacist could "verify" all the orders at once with a single command. Of course that was before any online interaction screening, and I'm not suggesting that Meditech implement such a feature, but that's the transition we went through a decade ago.

Steven Dailey, RPh
Pharmacist/Information Services
Union Hospital
Elkton, MD  21921

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"Charlie Downs" <dow...@wchsys.org> Sent by: medit...@mtusers.com 03/09/2007 02:55 PM

To "Makara, Susan" <Susan....@interiorhealth.ca>, <medit...@mtusers.com> cc

Subject Re: [MEDITECH-L] PHARMACY VERIFICATION

Hi all:

Susan

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[cea...@hsd.cccounty.us]

I think I know why the pharmacists are getting all the flags. It is because the order "set" has been "entered" by the technician. So now there are
individual
unverified orders for the Pharmacist to verify, so they are no longer together in the "set" for the override prompt to be able to control them.
I have yet another issue with verification. Our night contract pharmacists use techs to enter orders and then the verify the orders.
If they use the VER function they get no green print label pop up screen, so we don't get labels for meds that have to be made in the morning.
However, if they use the VEC function, then enter a V, they get the green print screen. I have had this task ongoing for several months now.
I also had an issue with rules flagging at inappropriate times during verification (IE rules that should flag only on schedule 2 meds were flagging all the
time)
There is a DTS for this. I will have to find it if you need it. Cindy

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"Charlie Downs" <dow...@wchsys.org>
Sent by: medit...@MTUsers.com
To
"Makara, Susan" <Susan....@interiorhealth.ca>, <medit...@MTUsers.com>
03/13/2007 10:03 PM cc

Subject
Re: [MEDITECH-L] PHARMACY VERIFICATION

Hi all:

Susan

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