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Prepared by: Nevika Krishinchand Date : 12 September 2013

iMix 2013 Integrated and Informative Decision Support for Health Care Providers across Pharmacy and CPOE. Prepared by: Nevika Krishinchand Date : 12 September 2013. Agenda. Introduction Decision Support Mechanisms Monographs Interactions Drug-Drug Food Allergy Warnings Order Sets

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Prepared by: Nevika Krishinchand Date : 12 September 2013

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  1. iMix 2013 Integrated and Informative Decision Support for Health Care Providers across Pharmacy and CPOE Prepared by: NevikaKrishinchand Date : 12 September 2013

  2. Agenda • Introduction • Decision Support Mechanisms • Monographs • Interactions • Drug-Drug • Food • Allergy Warnings • Order Sets • Suggested Orders • Rules • Dose Range Checking • Notices • Lab Tests Linked to Drugs and Orders • Lab Test Results on Patient Profile • Dosing Sets

  3. MEDITECH Decision Support Introduction WHO estimates that more that half of all medicines are prescribed, dispensed of sold inappropriately Some examples of irrational use of medicines include • Poly pharmacy • Inappropriate use of antimicrobials • Overuse of injections when oral formulations would be more appropriate • Failure to prescribe in accordance with clinical guidelines

  4. MEDITECH Decision Support Introduction • 5 Rights of Medication Management • Right Patient • Right Medication • Right Dosage • Right Route • Right Time • Dictionaries that support this Decision Support: • Order Management • Pharmacy • MIS

  5. MEDITECH Decision Support Scenario 1 • Patient Helen Mercier • 60 year old female • Diabetic since 2005 • Severe allergy to Macrolides • Maintained at home on • Furosemide • Enalapril • Glyburide • Metformin • Reason for Admission • Pneumonia

  6. MEDITECH Decision Support Scenario 1

  7. Scenario 1 OM Orders Reconcile….Monographs

  8. Scenario 1 Monographs

  9. Scenario 1 OM Orders Reconcile..Check for Conflicts

  10. Scenario 1 OM Drug Interaction Conflict

  11. Scenario 1 OM Override Interaction

  12. Scenario 1 OM Order Sets

  13. Scenario 1 OM Allergy Conflict

  14. Scenario 1 OM Food Interaction Conflict

  15. Scenario 1 OM Suggested Orders

  16. Scenario 1 Rules

  17. Scenario 1 OM Dose Range Checking

  18. Scenario 1 PHA Dose Range Dictionary • Defined for a condition, age range and route • Daily Low • Daily High • Daily Max • Max Single Dose • Low, High and Max Duration • Low, High and Max Frequency • Are Renal and Hepatic assessment indicators to be checked?

  19. Scenario 1 OM Conflict Check on File

  20. Scenario 1 OM Notices

  21. Scenario 1 Pharmacy Desktop -> New Activity

  22. Scenario 1 Pharmacy Desktop->Patient Profile->Allergy Warning

  23. Scenario 1 Pharmacy Desktop->Patient Profile

  24. Scenario 1 Pharmacy Desktop->Patient Profile->Rules

  25. Scenario 1 Pharmacy Desktop->Verify -> Interaction Checking

  26. MEDITECH Decision Support Scenario 2 • Ebrahim Mohammed • 75 year old male • Hypertensive since 1990 • Maintained at home on • Furosemide • Enalapril • Lipid profile ordered on previous visit

  27. Scenario 2

  28. Scenario 2 OM Lab Results Linked to Orders

  29. Scenario 2 Pharmacy -> Lab Results Linked to Drugs

  30. MEDITECH Decision Support Scenario 3 • Johan Smith • 4 year old male • Admitted for a severe allergic reaction

  31. Scenario 3 OM Weight Based Dosing -> Dosing Set Dictionary

  32. Scenario 3 OM Weight Based Dosing

  33. Scenario 3 OM Weight Based Dosing -> Dosing Sets

  34. MEDITECH Decision Support Conclusion How can MEDITECH’s Decision Support Tools Benefit the end user? • Provide clinicians with instant access to evidence based medicine to help guide their decision making • Establish Best Practices • Promote Rational Drug Use • Flag potential medical errors before they occur • Decrease patient length of stay .....lower costs How can MEDITECH’s Decision Support Tools Benefit the patient? • Enhances patient care • Reduce patient complications • Improve Patient Safety

  35. Thank you

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