Hospital Pharmacists: Protecting Patients From Electronic Medical Record Errors May Be Their Most Important New Role
Most hospitalized patients and families don’t realize that life-threatening medication errors are regularly thwarted by pharmacists. They are truly the unsung heroes of patient care. I just finished a locum tenens assignment at a hospital that uses EPIC as their electronic medical records system, and I was stunned by the impossibly complex medication reconciliation process. Each time a patient is admitted to the hospital, or transferred to another part of the hospital, a physician must review, approve, and re-order their medications. While this may seem like a good way to insure that medication errors are avoided, it actually has the exact opposite effect.
Because EPIC keeps lists of home meds, discontinued meds, and current meds available for review and reactivation, it takes little more than one misplaced check box to order the wrong dose or type of medication. Physicians who transfer a patient to another service can indicate their intended medication list and keep it “on hold” for the receiving physician to review and approve. Unfortunately, the software’s tab system is so complex that it’s extremely difficult to find that list and activate it. Lost in a sea of admissions tasks and order boxes in different fonts, colors, and drop down menus, one often accidentally reviews and approves discontinued types and doses of medicines. The only protection against such errors is the hospital pharmacist.
With each new admission to the inpatient rehabilitation unit, I had to resort to calling a pharmacist for help. I was terrified that I would accidentally insert medication errors into the patient’s order set by carrying forward discontinued meds. The long-suffering pharmacists explained to me that “most physicians make medication order errors in EPIC with each admission.” They said that they regularly had to talk physicians out of throwing their computer out the window in a state of extreme frustration. They also said that their EPIC user environment looked very different (and less confusing) than what the physicians used, so that they couldn’t even provide real-time phone guidance regarding order entry process.
The scary thing is that EPIC has the largest market share of any EMR in the United States. It is also (in my experience) the most prone to medical errors due to its overly complex medication reconciliation process. I have used other EMRs that have far simpler and more intelligent medication order entry processes. Soarian (Sieman’s EMR, just sold to Cerner) has, for example, an outstanding order entry system. So my complaint is not that “all EMRs are bad” – it’s that some have particularly flawed designs that are causing real harm to untold millions of patients. We just haven’t documented the harm yet. I tremble at the thought of what we’d find.
Until electronic medication reconciliation is made safer, pharmacists will be working overtime to correct records and protect patients from carry over errors. I thank my lucky stars that I have had vigilant, determined pharmacists by my side as I cared for very complex, sick patients who were exceptionally vulnerable to dosing errors. There has never been a more important time to exercise caution when entering hospital medication orders, or to express your appreciation for pharmacists. Without their help we might all be experiencing medication errors of EPIC proportions.
Aw, this was an extremely good post. Finding the time and actual effort to
make a great article… but what can I say… I procrastinate a lot and never seem to get anything done.
Hi there colleagues, its impressive piece of writing regarding educationand entirely defined, keep it up all
the time.
com bevatten ook een nieuwe functie die beschikbaar is in bepaalde steden. Dit
soort portals zijn zeer gemakkelijk te gebruiken: u
hoeft maar om de titel van de show. U hebt de mogelijkheid om te kijken naar vrijwel elke live-wedstrijd voor vrijwel elke sport over de hele wereld.
Christian Louboutin semelle rouge chaussures de femmes, louboutin pas cher livraison gratuite en ligne soldes.
De christian louboutin pas cher
Where to buy cheap michael kors bags that are highly replica in good
quality? Our michael kors facotry outlet website here!
We offer 100% quality guaranteed knock off handbags, wallets at the competitive lowest price online, free shipping!
more from : cheap fake michael kors bags
I loved as much as you’ll receive carried out right here.
The sketch is attractive, your authored subject matter stylish.
nonetheless, you command get bought an edginess over that you wish be delivering the following.
unwell unquestionably come further formerly again as exactly the same nearly very often inside case you shield this increase.
Pretty! This was an incredibly wonderful article. Thank you for providing this information.
I am actually happy to glance at this webpage posts which contains plenty of useful data,
thanks for providing these kinds of statistics.
Ahaa, its fastidious discussion on the topic of this post here at
this website, I have read all that, so at this time me also commenting here.
If some one wishes expert view on the topic of blogging after that i propose him/her to pay a visit this weblog, Keep up the nice work.
My partner and I stumbled over here from a different page and thought I may as well
check things out. I like what I see so now i am following
you. Look forward to checking out your web page yet again.
Hello! I’ve been reading your weblog for some time now and finally got the bravery to go ahead and give you a shout out from Austin Texas!
Just wanted to mention keep up the excellent work!
Eѵeryone loves ѡat you guys aгe up toо. This kind oof clever worк ɑnd coverage!
Keep uρ thе excellent ѡorks guy I’νe ɑdded ƴoս guys tοo mʏ own blogroll.
My brother suggested I might like this web site. He was
entirely right. This post actually made my day. You cann’t imagine
simply how much time I had spent for this information! Thanks!