Frequently Asked Questions.
How can CPOE overcome formulary challenges when providers prescribe or continue from ambulatory a non-formulary medication?

Healthien has an innovative solution, leveraging MEDITECH capabilities by the use of reflex orders and NPR rules. The solution would allow providers to order non-formulary medication, and the system will automatically substitute the medication with a formulary item approved by the P&T automatic substitution policy. This solution will yield the highest score of Provider Order Entry for Meaningful Use attestation and reporting, as well as reducing the pharmacist order entry work load. This solution also functions as added Clinical Decision Support system; it provides physicians with the correct dose and schedule for the therapeutic interchange, saving the provider literature search time, as well as enhancing patient safety and Medication Reconciliation process.

Heparin Induced Thrombocytopenia (HIT), Meaningful Use Clinical Quality Measure became a challenge to our nurses. Is there a solution to automate this process?

CDS nursing assessment can be built and attached to Heparin drugs, with attributes to automatically populate platelet count baseline and current values. Those attributes can also automatically calculate the change from base line and provide a sound clinical decision support based on quality measures criteria.

Nurses are complaining about administration times of IV solutions being displayed on the EMAR, which makes it cumbersome to constantly have to change administration times when IV runs out. How can this problem be solved?

Order type build is critical for the build of IV drugs in CPOE. More than one order type should be built for the different types of IVs. IV administered on a set schedule such as Antibiotics should have an order type to dispense by “SIG”, other maintenance infusions should have an order type to dispense by “Duration” and calculate by rate.

Why are Providers having many issues with RXM during e-prescribing and Medication Reconciliation ?

The following are some of the reasons:

  • Organization maybe using their old pre-E-prescribing RXM content. RXM dictionary used in the old systems before e-prescribing are no longer valid for use with e-prescribing and Med Rec. Such system must be expunged and new Formulary Service Vendor (FSV) content must be loaded, and rebuilt.
  • Organization may have expunged the old system and reloaded a new FSV load, and stated using it with little or no build. Most of the time, the FSV data are not perfect, they are missing critical information, such as drug strength and/or form, and drug names may be missing information. Such information is critical to providers and electronic transmission to retail pharmacies
  • Order strings maybe missing important data, or maybe loaded from a third party vendor without cleanup or optimization.
Why do we have poor physician adoption of our Meditech CPOE system?

Any CPOE system, whether is Meditech or any other vendor, should be built with a provider friendly focus. Organizations often have their internal resources, normally pharmacists or a pharmacy technician build the system. Without adequate CPOE implementation experience, the system may be built from a pharmacist perspective rather than a physician perspective. Advanced clinical implementation requires strong clinical knowledge combined with extensive Meditech build experience. Ideally, an IT pharmacist consultant with strong clinical and analytical skills as well as Meditech experience can build a Physician-friendly system. Also, NPR knowledge is preferred.

Is there a way to automate Heparin protocol in Meditech magic?

Yes, a Pharmacy/Nursing Customer Defined Screen (CDS) can be built with attributes to automatically populate the patient data (such as height and weight) and most recent lab values, and would also automatically calculate change in rate/dose based on the populated values . The CDS would then be attached as NUR assessment on the Heparin Drug.