By

Sandra Herr, RN

-electronically generated prescription -ability to utilize EMR (electronic medical

record) -accurate, error-free and

understandable -improving the quality of patient care -reducing medication errors -use of palm pilot or computer

-patient safety -renew prescriptions -time management -accurate medication

reconciliations -recognize drug interactions -more interaction with patients

-time saving -expensive software -integrated EMR -limited usage -fast -extensive training -legible -complexity

(Kilbridge and Gladysheva 2001)

- transceiver - connects a computer to a fax or phone

line - high speed internet access - ability to use a phone while e-

prescribing - can use exisiting phone line

connection

- All scripts - Dr. First - MedPlus, Inc - Surescripts - ZixCorp - RxNT - Prematics - Misys eScript (AMCP.org)

- used daily in all 50 states - merger of RxHub / Surescripts - formed with CVS Caremark Corp,

Express Scripts Inc and MedCo Health Solutions, Inc

- connects over 10,000 pharmacies nationwide

- user centered design and focus - ongoing education - simplicity - safe - secure - fast

Reflect on any experiences you may have had recently…thoughts?

-Patient centered

-Integrated health care

-Comprehensive

Used By:

-Physicians and nurses

-Billing/financial

-Administration

-Clinics

-Pharmacy

-Laboratory

-Radiology

-Clergy (hospital based)

-Social Service

Functions:

-Accurate Medication Reconciliation

-Documentation

-Billing

-Continuity of Care

-Discharge planning

-Patient centered care

-Error reduction

-Increased patient safety

-Spiritual/social

MAINFRAME-interface between hardware and user

-sharing of resources-simplifies development of applications

-multitasking system-saves data to memory

-shared data

Data Standards:

-Healthcare level 7(HL7)-American Society for

Testing and Material-Healthcare Informatics

Standards Planning Panel-Workgroups for Electronic

Data Exchange-American National

Standards Institute (ANSI)

(Goedert 2006)

Disease/Procedure Classification System(s):

-International Statistical and Classification of Diseases and Related Health Problems (ICD-9 or ICD-10)

-Systematized Nomenclature of Medicine (SNOMED)

(Devine, Hansen, Hollingworth, Sullivan 2007)

-patient safety -decrease in medication errors -continuity of care -team collaboration -time saving -cost effective -patient centered

HIGHLY RECOMMEND EMR AND E-PRESCRIBE

FUTURE OF HEALTHCARE

A HEATHCARE WAVE FOR THE FUTURE

(Aspen, Wolcott, Bootman, Cronenwett, 1996)

(Bizzarro, 2009)

Prevents medication prescription errors

Eliminates illegible prescriptions Provides for real-time

communications between doctors, pharmacies and patients

Provides critical drug alerts Patient specific information –

readily available Provides drug pricing information Provides payer coverage and

preferred drug information Complete patient medication

history Reduces fraud and crime Increases health care professional

work efficiency and reduces administrative costs

Speedy refills

Lack of integration with patient record Likelihood that it will be replaced

when EMR is adopted Reduced staff time spent on refill

process Lack of integration with patient

record Initial cost to implement Implementation and extensive

training of staff Educational costs to train staff Need for extensive training time for

all staff and outside vendors Unwillingness of staff compliance

and/or acceptance to change Selection based on criteria and need Development of an integration

system with outside vendors and pharmacies

-potential revenue sources from partnering with device vendors

-objective outcome by E-prescribing vendors

-vendors ties to the pharmaceutical industry

- Will HIPAA regulations limit what can be done with data

-registered nurse -computer skills

-informatics knowledge -informatics skills

-education and training -mentoring for new/seasoned staff -super user in EMR (electronic medical

record) -community liaison for pharmacy and

physician practices -accessibility to staff -continued research and education

California Health Care Foundation. (2001). Retrieved September 17th, 2009 from http://quality.chcf.org/documents/hospitals/EPrescribing.pdf

U.S. Department of Health & Human Services (2009). Retrieved September 18th, 2009 from http://www.cms.hhs.gov/eprescribing/

Centers for Medicare and Medicaid Services (2008). Retrieved September 18th, 2009 from http://www.medicare.gov/Publications/Pubs/pdf/11382.pdf

- FREE electronic prescribing…for every physician in America. (2008). Retrieved October 9th, 2009 from http://www.nationalerx.com

Bringing high-speed e-medicine to Pa. physicians. (2008). Retrieved October 8th, 2009 from http://www.physiciansnews.com/spotlight/808pa.html

Dermatology Online Journal Volume 7 Number 1. (2001). Retrieved October 11th, 2009 from http://dermatology.cdlib.org/DOJvol7num1/media_review/ephysician/goldblum.html

Surescripts. (2009). Retrieved October 11th, 2009 from http://www.surescripts.net/the-company.html

Indiana University – University Technology Services (2005-2009). Retrieved October 11th, 2009 from http://kb.iu.edu/data/ajfr.html

-Electronic Health Record . (2009). Retrieved October 29th, 2009 from http://en.wikipedia.org/wiki/Electronic_health_record

-Operating Systems. (2009). Retrieved October 29th, 2009 from http://en.wikipedia.org/wiki/Operating_system

-The Evolution of EMR Standards. (2006). Retrieved October 30th, 2009 from http://www.healthdatamanagement.com/issues/20060501/13354-1.html

- Implementing an Ambulatory e-Prescribing System: Strategies Employed and Lessons Learned to Minimize Unintended Consequences . (2007). Retrieved from http://www.ahrq.gov/downloads/pub/advances2/vol4/Advances-Devine_83.pdf

Guideposts to the Future—An Agenda for Nursing Informatics. (2007). Retrieved November 19th, 2009 from http://www.jamia.org/cgi/content/abstract/14/1/.

e-Prescribing Technology: Issues and Policy Implications in a Dynamic Market. (2001). Retrieved November 20th, 2009 from

http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102273470.html.

Integrating evidence into clinical information systems for nursing decision support. (2007). Retrieved November 21st, 2009 from http://www.ijmijournal.com/article/S1386-5056(07)00162-1/abstract.

AMA announces partnership with e-prescribing vendor. (2009). Retrieved November 22nd, 2009 from http://www.ama-assn.org/amednews/2009/07/27/bisd0730.htm

Preventing Medication Errors: Quality Chasm Series. (1996). Retrieved November 22nd, 2009 from http://www.nap.edu/catalog.php?record_id=11623

e-Prescribing Briefing Managed Care Pharmacy 101 New York Health Plan Association (2009). Retrieved November 22nd, 2009 from www.hixny.org .