Information Technology in the Inpatient Setting - Orientation

1. Information Technology in the Inpatient Setting - Orientation July, 2011

2. Course Objectives At the end of this session, participants should be able to: • Describe how healthcare organizations can utilize safety strategies and reduce the risk of medication and other errors by implementing technology at different points along the medication use process • Analyze medication and other patient-related information captured in patient care information systems • Examine the risk of medication and errors and consequences in patient safety for improperly configured systems • Delineate the process of provider order entry and order completion by pharmacy and explain the pharmacist’s role. • Appraise the need for standardization throughout the clinical information technology system, including use of a standardized menu structure. • Recognize the potential impact of the Institute of Medicine (IOM) recommendations and available medication management technologies on patient safety

3. Benefits of Information Technology in providing medical care1 • Computerized prescriber-order-entry systems integrated with electronic health records (EHRs) and pharmacy information systems, • Clinical decision-support tools that bring best-practice information and guidelines to clinicians at the time they need them and rule-based systems for monitoring, evaluating, responding, and reconciling medication-related events and information, • Pharmacy information systems that allow electronic validation of medication orders in real time, provide the data flow needed to update both the medication administration record and order-driven medication dispensing systems, and support such operational activities as supply-chain management and revenue compliance, • Automated dispensing cabinets and robotics integrated or interfaced with pharmacy information systems, • Integrated medication administration management systems that enable the administration of bar-coded medications and use of “smart” infusion pumps, and • Integrated medication surveillance applications for the reporting of medication incidents and adverse events.

4. Pharmacy informaticist Role1 Leadership. Pharmacists are responsible for patient safety throughout the medication-use process and need to take a leadership role in medical informatics at all levels of health care to ensure that health information technology supports safe medication use. Pharmacy informaticists must use their skills to • Provide leadership to the institution’s committees (e.g., practice, safety and quality, technology, pharmacy and therapeutics), • Collaborate with other health care technology and clinical leaders to ensure that medication-related systems support interoperability and transportability of • clinical information while maintaining patient safety and confidentiality, • Attain key leadership roles within the health care technology industry, professional practice associations, and health care technology organizations, and • Lead governmental and regulatory groups to sound conclusions regarding the use of technology in medication management, particularly as it relates to setting standards.

5. Pharmacists and Information Technology1 Pharmacists have the unique knowledge, expertise, and responsibility to assume a significant role in medical informatics. As governments and the health care community develop strategic plans for the widespread adoption of health information technology, pharmacists must use their knowledge of information systems and the medication-use process to improve patient care by ensuring that new technologies lead to safer and more effective medication use. 1 American Society of Health-System Pharmacists. ASHP statement on the pharmacist’s role in informatics. Am J Health-Syst Pharm. 2007; 64:200–3. http://www.ashp.org/DocLibrary/BestPractices/AutoITStInformatics.aspx accessed 6/29/2011

6. ISMP Safe Medication Practices Recommendations2 • CPOE • Avoids transcription errors • Automated Dispensing Machines • Assures correct medication is picked • BCMA • Assures 5 “Rights” of medication administration • Avoid Look-alike packaging • Prevents incorrect drug selection • Especially important with high-risk drugs • Standardization/Simplification • Commercial preps, print names, abbreviations, formulations/concentrations 2Institute for Safe Medication Practices, Overview of Safety Recommendations for Medication Management Technology, 2011. http://www.ismp.org/CE/medmanagementtech/Default.asp Accessed 6/29/2011 (This and the next four slides)

11. Requirements of Medical Information Technology Systems • Security • correct system access • correct user ID • Protect sensitive patient data • Ability to capture and correct information • Patient Information • Patient problems • CPOE • System data checks • Drug/Drug and Drug/Allergy checks • Ability to communicate to and between users • Notifications • Notes • Ability to track changes

12. RPMS as a Medical Information Technology System • Security • Access and Verify Codes • Access assigned by role • Encryption of data • Ability to capture and correct information • Patient Registration in RPMS (and now GUI) • EHR captures visit elements and patient data • CPOE is a featured element of EHR • System data checks • Drug/Drug and Drug/Allergy checks • Ability to communicate to and between users • Notifications • Notes • Ability to track changes • RPMS records identity of user making changes

13. Learn about RPMS • For Basic learners: • Presentation 3.15 – RPMS BASIC Instructions from FTP site ftp://ftp.ihs.gov/pubs/EHR/Training/Manuals/ • For more advanced learners: • 3.2 – ScreenMan Key Shortcuts • 3.3 – Pharmacy Key Template • 3.4 – Recommended Pharmacy Patches and Taskman jobs • 3.5 – Obtaining Help for Pharmacy Issues