New electronic system improves efficiency in pharmacist reviews
Problem medications quickly pop up
While it's important to have a good medication management tracking tool, the data collected isn't useful unless it's used to improve patient safety and outcomes, experts say.
"You can't just collect numbers," says Alex Melchert, MS, RPh, director of pharmacy at New York Hospital Queens in Flushing, NY.
"You have to be able to look at numbers and see where you can make some sort of improvement," Melchert says.
For instance, Melchert uses medication management data collected through Pharmacy OneSource's Quantifi program to focus on high-alert medications, meet standards by the Joint Commission of Oakbrook Terrace, IL, and to report to the hospital's pharmacy and therapeutics committee and medical board.
Also, Quantifi works in conjunction with Pharmacy OneSource's latest electronic medication management system called Sentri7, which brings data to the individual level.
Sentri7 provides pharmacists with a dashboard that helps to break down data to the patient level so they can identify which patients to target for interventions, says Charles Westergard, BsPharm, MBA, vice president of clinical affairs of Pharmacy OneSource Inc. of Bellevue, WA.
For example, Sentri7 will show patients' individual medication use data and highlight in red print where a lab value is out of range for a particular drug, he says.
Then in small print it lists a suggested action for what the pharmacist should do when it sees this red flag.
While the 170 hospitals using Sentri7 have basically the same clinical categories, each might have some differences in their intervention programs, and the software enables them to adjust the rules according to their own standards.
"We leave it up to clinicians to build out the logical rules that pertain to patients," Westergard says.
At New York Hospital Queens, Sentri7 helps pharmacists save time by narrowing down the medication profiles they need to review, Melchert says.
"The usual routine is that clinical pharmacists come in and look at areas for which they're responsible, print out profiles, and find areas for improvement," he explains. "But they'll have to look at a lot of information they don't need because not every patient needs an intervention."
With the detailed data mining capability of an electronic medication management program, pharmacists can decide to look at all patients taking warfarin who have a lab value for INR greater than 2.5, Melchert says.
"The program will ignore everyone who has a lower lab value than that," he says. "It allows you to fine tune the process and saves you from looking at patients who are stabilized."
A pharmacist could decide to check all patients with impaired renal function who have been prescribed a particular drug that might impact renal function, and initiate an intervention this way, he adds.
"You tell the program what you want it to look for, and you define your terms," Melchert says. "It could look at only certain high-risk populations of elderly individuals with impaired renal function who are on an antibiotic that impairs their renal function."
The clinical pharmacist team looks at evidenced-based data and modifies the electronic program based on new standards and data.
"We had a recent modification about having a more aggressive approach to glucose monitoring because of recommendations from the American Diabetic Association and the American Medical Association," Melchert says.
"The program is limitless; it can look at lab work or anything, and you just need the proper training to find it," he says. "It allows my staff to look at far more patients in the high-risk drug population categories than we would ordinarily be able to do."
While it's important to have a good medication management tracking tool, the data collected isn't useful unless it's used to improve patient safety and outcomes, experts say.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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