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Improving E-Prescribing Rates at Broadway Practice. Attendings : Heidi Beutler , Mariellen Lane, John Rausch, Laura-Robbins-Milne, Nan Salamon Rene Eis
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Improving E-Prescribing Rates at Broadway Practice Attendings: Heidi Beutler, Mariellen Lane, John Rausch, Laura-Robbins-Milne, Nan Salamon Rene Eis Residents: UchechiAzubuine, Dominique D. Bailey, Amy E. Dipilato, Jessica M. George, Pamela Good, Joseph A. Grillo, Anna F. Hays, Michelle S. Jamison, Erin A. Paul, AnoopV. Rao, GauriR. Raval, Meg R. Ray, ArashSalavitabar, Kristen E. Schratz, Andrew M. Silverman, Katherine Still, Rebecca Tamez, Jennifer Taylor, Thomas Wallach RNs: Sally Ortiz, HaydeeBayon, Becky Ofori Registration Coordinator: Ingrid Miranda MAs: Celia Mendez, Blanca Cordero, Reina Quiroz, Felipe Joaquin PFAs: ConchitaLaurencio, Evelyn Reyes, Shirley Laurencio, IraidaTorres
AIM • To increase the rate of e-Prescribing to 75% among all providers at the Broadway Clinic by the end of the academic year (June 2014) • Where we were: • Broadway Rate: 48% • Resident Rates- 45% • Attending Rates- 51% • Preferred pharmacy information: • 41.9% of patients had a preferred pharmacy listed in Eclypsis
Decreased medication errors • Prescribing error rates in children are estimated to be between 5% and 27% in a systematic review (Miller 2007) • Two studies looking at the difference between handwritten and e-prescribed medications found a significant reduction in error rates (Jani 2008, Ammenwerth 2008) • Some studies have shown that eliminating this step may also contribute to decreasing medication and dosing errors (Moniz 2011). • e-prescribing nearly halved the risk of dispensing errors compared with EMR-generated paper script
Increase communication • Immediate clarification • Allows for generic substitution • Avoiding higher copayments can improve medication adherence (Stenner 2010) • Pharmacies can give immediate feedback
Barriers to e-Prescribing Before After n=15 n=13 n=4 n=1 n=6 n=5 n=2
Interventions at Broadway • Education: • Provider education on benefits of ePrescribing • Provider review of how to ePrescribe • MAs, Nurses and PFAs were taught how to input pharmacy information
Feedback and Access • Resident E-Rx report cards • Pharmacy map • Staff input of preferred pharmacy • Televox message updated
Preferred Pharmacies Hudson River 10463 10458 10457 10456 10034 10468 10040 10453 10033 10032 10452
Parent Opinions • “Pre” survey Block 6: • 1 had never gotten an e-prescription • 1 preferred paper prescriptions because they don't have a single pharmacy that they like yet • 3 said e-prescriptions are better • “Post” survey Block 9: • 8 pts knew of ePrescribe services and preferred it • “its easier,” “its faster,” “I used to lose all those paper ones.”
Spread the Word! • Pharmacy Map • Resident eRx rates • Staff Training • Reporting Problems