Medication ordering and ePrescribing

ePrescribing will be much more important in 2017 as it is expected to be a mandatory component of Meaningful Use for eligible hospitals. Anupam discussed the advantages and disadvantages of having one or two metrics to track medication ordering in-house (traditional CPOE) and ePrescribing for discharge medications. The group discussed the challenges around ePrescribing including:

• Pharmacy challenges
  • Searching for the pharmacy if it is not already entered
  • Reassigning a pharmacy if the patient makes a change
• No way to recall a prescription if sent in error
• Unable to e-prescribe controlled substances

The group was also concerned about the appropriate attribution for orders that were not ePrescribed but written out as they may not be entered into CareConnection. Handwritten prescriptions also cause challenges with appropriate discharge medication reconciliation.

[ ] Anupam to follow-up with Nursing around entering the patient's preferred pharmacy as part of the admission intake process.
[ ] Both inpatient and outpatient electronic medical record systems are scheduled for capital investments for ePrescribing controlled substances.

Substituting transcription dollars for physician education dollars

Anupam presented the group with a proposal to use some of the transcription dollars for physician education resources. The group had several questions about how this transition might occur. Some of the comments included:

• Can we definitively state that education leads to improved EMR use?
• How do physicians incorporate new information into their workflow?
• What is the most cost-effective way to encourage change?
• Many sites would like 1:1 sessions to develop tailored EMR enhancement opportunities.
• Voice-to-text training could be accompanied with workflow optimization in other areas like Chart Review or Discharge Summary preparation.

Another approach might be to focus on the top three frustrations that high-volume users face and address those through targeted education or EMR enhancement. The group was not clear if the organization would support an ongoing cost for physician education rather than a time-limited engagement.

[ ] Anupam to follow-up with the VPMMs and Vince Bufalino to gauge the appetite for such a change.

Copy and Paste

Anupam demonstrated the copy-and-paste identification functionality that is available outside CareConnection. Advocate is expected to generate a policy around copy-and-paste before the end of the year.

Icon and banner notification for Advocate's covered lives

Issues from prior meetings

[] If the signature + specialty request (with changing the resident's specialty with each rotation) and SmartTemplate work are performed by separate teams, then we will proceed down both paths simultaneously. Otherwise, we will work on the SmartTemplate request first before adding troponin in the daily labs SmartTemplate.
[] Anupam is still waiting to hear back from the Advance Care Planning Council about changing the requirement for a physical signature for LET orders.

Next meeting October 13th 0730-0830 hours CDT via Telepresence and telephone call.

Click here to see minutes from earlier meetings.