[MT-L] POM TRANSFER ORDERS - INTERACTIONS - MAGIC 5.66

[Loso, Tina]

Hello – We recently started using the transfer and receive function in POM. When a provider overrides or views the interaction the order is being held in nursing as unverified and does not cross to pharmacy until nursing acknowledges the order an sees the interactions. Meditech says this is the way it the transfer routine should be working. Has anyone found a way to NOT have nursing review the duplicates and interactions? What are other sites doing with this?

 

Thank you!

 

Tina Loso, CPhT

IS Analyst

Central Vermont Medical Center

802.371.4584

 

[Gast, Judith A., R.N.]

There is a focus group meeting as we speak to change the interaction checking to occur when physician first starts transfer routine rather than when nurse processes it…

 

 

Have a Great Day!

 

Judi Gast RN, BSN

EDM Project Manager

IT Analyst

Information Technology

912-287-4241

Fax: 912-287-2579

gast....@mayo.edu

__________________________________________

Mayo Clinic Health System in Waycross

1900 Tebeau Street

Waycross, GA 31501

mayoclinichealthsystem.org

[Christina Reynolds]

UNV meds do not show up on the EMAR but will show up in ACK orders on the SB (we are magic).  Nurses are trained to not ACK UNV med orders until PHARMACY Verifies them. 

 

Pharmacy can see all UNV meds in PHA.  They are responsible for verifying.  Nurses ACK them prior to administration.

 

Chris

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[Christina Reynolds]

To clarify the TRANSFER part – our nurses do have to RECEIVE the orders first…then they flow to PHA as UNV meds.

[Jeff Lee]

We felt this was a major issue, but WAD.  I’m not sure if they are reviewing this for potential changes, but rather than hang the nurse when <receiving> orders while they fill in required override reasons, the option was to let it go to unvPHA which doesn’t flow to PHA and it is expected that nurses would pick up on this OE suspended order and address. 

 

We found this was NOT happening and orders where being “missed”.  Our option was to turn off interaction checking, which for pre-in patient situations (where we also use <transfer>), then known allergies can be skipped with that setup.  We didn’t like that option.

 

We decided to ultimately schedule a NPR report to run hourly and print to pharmacy searching for unvPHA orders and then the pharmacy addresses them in a “timely” manner.

 

Jeff

 

From: Meditech-l [mailto:meditech-...@mtusers.com] On Behalf Of Loso, Tina
Sent: Tuesday, February 11, 2014 2:06 PM
To: Meditech-L (medit...@mtusers.com)
Subject: [MT-L] POM TRANSFER ORDERS - INTERACTIONS - MAGIC 5.66

 

Hello – We recently started using the transfer and receive function in POM. When a provider overrides or views the interaction the order is being held in nursing as unverified and does not cross to pharmacy until nursing acknowledges the order an sees the interactions. Meditech says this is the way it the transfer routine should be working. Has anyone found a way to NOT have nursing review the duplicates and interactions? What are other sites doing with this?

---

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[Melissa Wyant]

Hi Tina,

We are Magic 5.66 and our nurses that receive the transfer do not see the Interaction or Duplicate checking.  We created a MIS Interaction/Conflict group specific for Nursing and transfer with all of the prompts set to "N".

This interaction/Conflict group is attached in the OE Access Dictionary for the nurses on page  one under the MIS Interact/Conflict Group Receiving a Transfer section.

 

This will prevent the users in this access group from seeing the interaction checking when they receive the transfers.

 

Hope this helps,

 

Melissa

 

 

 

 

Melissa Wyant, R.Ph.
Pharmacy Application Analyst, IS
Holyoke Medical Center
Phone: 413-534-2842
>>> On 2/11/2014 at 15:05, in message <EA65C0A5B109D9469005...@CVMC-EMAILMBX1.CVMC.ORG>, "Loso, Tina" <Tina...@cvmc.org> wrote:

Hello - We recently started using the transfer and receive function in POM. When a provider overrides or views the interaction the order is being held in nursing as unverified and does not cross to pharmacy until nursing acknowledges the order an sees the interactions. Meditech says this is the way it the transfer routine should be working. Has anyone found a way to NOT have nursing review the duplicates and interactions? What are other sites doing with this?

CONFIDENTIALITY NOTICE: This email communication and any attachments may contain confidential and privileged information for the use of the designated recipients named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please reply to the sender immediately and destroy all copies of this communication and any attachments.

[Gast, Judith A., R.N.]

As the transfer routine is set up right now…that would just mean that no one would see the interactions and conflicts, correct?   Maybe I am just not understanding it correctly.  Because the way the transfer routine is set up at this moment (my understanding at least) is that orders do not go through conflict checking until they are saved…so when the doctor first starts ordered in transfer and sets all their orders up, no conflicts will show.  Then if you have it set the way you do, the nurse processes the transfer and does not get any conflicts upon saving, so now who figures out that the patient is allergic to PCN and was ordered amoxicillin?  Or has hx of recent epidural and your ordering Coumadin….or lovenox.   Not questioning what you’re doing, just trying to get it straight in my head.   Thanks so much…

 

 

Have a Great Day!

 

Judi Gast RN, BSN

EDM Project Manager

IT Analyst

Information Technology

912-287-4241

Fax: 912-287-2579

gast....@mayo.edu

__________________________________________

Mayo Clinic Health System in Waycross

1900 Tebeau Street

Waycross, GA 31501

mayoclinichealthsystem.org

 

[Melissa Wyant]

Hi Judith,

The Conflict group only impacts the Receive of the Transfer not placing the transfer orders.  For meds that are continued on Transfer the provider does not see the interaction checking again because this has already been addressed when the order is initially placed.  If new medications are ordered as part of the transfer process the provider will get all of the Allergy/Interaction/Duplicate checking prompts when they place the orders.  The pharmacy will also see the same interactions when they verify the new orders.

 

One thing that may make a different in how this functions for sites is the "Create New Orders Upon Transfer" OE Parameter.  We have ours set to "N."  Our facility determined that this was the best flow for continuing the same order and being able to determine how long someone was on a medication and when doses were given.  The PHA Audit trail for the order records that it was either continued or discontinued on transfer.  We also have the pharmacy set up to be flagged to Review all orders that are continued on Transfer.

Hope this explanation helps,

Melissa

 

 

Melissa Wyant, R.Ph.
Pharmacy Application Analyst, IS
Holyoke Medical Center
Phone: 413-534-2842

>>> On 2/12/2014 at 07:23, in message <6e55ab$8ba...@ironport10.mayo.edu>, "Gast, Judith A., R.N." <Gast....@mayo.edu> wrote:

As the transfer routine is set up right now.that would just mean that no one would see the interactions and conflicts, correct?   Maybe I am just not understanding it correctly.  Because the way the transfer routine is set up at this moment (my understanding at least) is that orders do not go through conflict checking until they are saved.so when the doctor first starts ordered in transfer and sets all their orders up, no conflicts will show.  Then if you have it set the way you do, the nurse processes the transfer and does not get any conflicts upon saving, so now who figures out that the patient is allergic to PCN and was ordered amoxicillin?  Or has hx of recent epidural and your ordering Coumadin..or lovenox.   Not questioning what you're doing, just trying to get it straight in my head.   Thanks so much.

Have a Great Day!   Judi Gast RN, BSN EDM Project Manager IT Analyst Information Technology 912-287-4241 Fax: 912-287-2579 gast....@mayo.edu __________________________________________ Mayo Clinic Health System in Waycross 1900 Tebeau Street Waycross, GA 31501 mayoclinichealthsystem.org   From: Meditech-l [mailto:meditech-...@mtusers.com] On Behalf Of Melissa Wyant Sent: Tuesday, February 11, 2014 4:20 PM To: Tina Loso; Meditech-L (medit...@mtusers.com) Subject: Re: [MT-L] POM TRANSFER ORDERS - INTERACTIONS - MAGIC 5.66

Hi Tina,

[Helgason, Mary Ellen]

We have also created a separate Interaction/conflict group for receiving transfers.  The nurse will have a different Interaction/conflict group for POM so he/she will get interaction checking when entering medication orders.

 

Mary Ellen Helgason, RPh

Clinical Informatics Pharmacist

Information Systems Dept.

 

803-865-4876 - office

803-487-2988 - mobile

 

 

From: Melissa Wyant [mailto:Wyant_...@holyokehealth.com]
Sent: Tuesday, February 11, 2014 4:20 PM
To: Tina Loso; Meditech-L (medit...@mtusers.com)
Subject: Re: [MT-L] POM TRANSFER ORDERS - INTERACTIONS - MAGIC 5.66

 

Hi Tina,

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[Helgason, Mary Ellen]

The provider does not get interaction checking when he/she continues meds in the transfer routine.  He/she will get interaction checking if any new medications are added to the transfer.  The nurse will not get any interaction checking when receiving the transfer.  Then the pharmacist will get the warnings when verifying the orders.

 

We are MAGIC 5.66 pp2.  In the OE access dictionary, we have two fields for interaction checking under the heading MIS Interaction/Conflict Group.  “POE” and “Receiving a Transfer” that allow different Interaction/Conflict checking by access group.

 

 

Mary Ellen Helgason, RPh

Clinical Informatics Pharmacist

Information Systems Dept.

 

803-865-4876 - office

803-487-2988 - mobile

 

 

This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.