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Drug File Management for Multidivisional Sites using EHR. Brian K. Johnston DPh Lieutenant, USPHS Clinical Application Coordinator Choctaw Nation Health Care Center Talihina, Oklahoma. Objectives:. Multiple Divisional Drug File vs. One Division Drug File
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Drug File Management for Multidivisional Sites using EHR Brian K. Johnston DPh Lieutenant, USPHS Clinical Application Coordinator Choctaw Nation Health Care Center Talihina, Oklahoma
Objectives: • Multiple Divisional Drug File vs. One Division Drug File • Formulary Management and Drug File Maintenance • Communication System for Formulary and EHR Changes
Choctaw Nation Health System • 145,000 ft² 37 Bed Hospital located in Talihina, OK • 6 Satellite Health Clinics • Mail Order/Refill Center (opening spring ’07) • ~100 Physicians and Mid-Levels • Multidivisional Database ran from Talihina’s Servers (EHR distributed by Citrix)
Multidivisional Drug File • Pros: • Each Pharmacy maintains their own Drug File (pro & con) • Custom Formularies based on Provider’s preferences • Open Access for Pharmacist’s Product Substitutions
Multidivisional Drug File (cont.) • Cons: • Physician Order Entry & EHR • Lots of Rx Editing • Renewing Orders in EHR • Outpatient Medications & Change “link” in EHR • Maintenance/Design of EHR & Drug File
One Divisional Drug File (Filtered) • Pros: • Standardization of Products • Limited Access to Drug File • Ease of Menu/Quick Order Creation in EHR • Solves Renewal Problem with Multidivisional Sites
One Divisional Drug File (cont.) • Cons: • Intense Formulary Management • May require an Acquisitioning Technician • Time require to convert all refills to single drug file • 10-15% of Products Revolve • Rx Editing Required
Formulary Management • Managing Multiple NDC’s • Pharmacy Director determines Generic substitutions • STOP McKesson’s product substitution • Small price changes DO NOT validate product switching • Drug File may contain Duplicates, Not EHR
Drug File Maintenance • 3 Pharmacists control Drug File (Staff Pharmacist, Inpatient Director and CAC) • All P&T changes available 1st of following month • Constant design required
Formulary Communication System • P&T determines approved Product & Dosage Forms • Pharmacy Director in coordination with Providers sets the standard strengths available • Acquisitioning Tech sends approved products information to Drug File Guardians • Acquisitioning Tech distributes list of specific items to all facilities
Formulary Communication System (cont.) • Drug File Guardian creates products in RPMS & EHR • New Products available 1st of following month after P&T meeting • All “tweaks” for products are emailed to Drug File Guardians
EHR Design/Development • Standardized View for Providers in EHR • “Global” Picture of Patient’s Records • Copying of Main Menus in EHR • Updating a sub-menu places items in all divisions • P&T Restrictions/Messages instantly seen by all facilities • Citrix Portal Access
bkjohnston@cnhsa.com ???Questions???