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Members of Eastern Health: Angliss Hospital, Box Hill Hospital, Healesville & District Hospital, Maroondah Hospital,
Peter James Centre, Turning Point Alcohol & Drug Centre, Wantirna Health, Yarra Ranges Health and Yarra Valley Community Health
Members of Eastern Health: Angliss Hospital, Box Hill Hospital, Healesville & District Hospital, Maroondah Hospital,
Peter James Centre, Turning Point Alcohol & Drug Centre, Wantirna Health, Yarra Ranges Health and Yarra Valley Community Health
Decision Support Designs for Cerner Millennium
Stephanie Chau
ehCare Clinical Application Pharmacist
Eastern Health
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Background
Eastern Health comprises of multiple sites and
provides to the public a wide variety of clinical
services:
Box Hill Hospital
Maroondah Hospital
Angliss Hospital
Peter James Centre
Wantirna Health
Healesville Hospital &Yarra Ranges Health
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State-wide Footprint • Collaboration between:
– Department of Health, Victoria (Health Shared Services)
– Austin Health
– Eastern Health
– Peninsula Health
– Royal Eye & Ear Hospital
• Points for consideration:
– Standardised customisations
– Reduced cost
– Collaboration and increased ideas gateway
– Increase in turnaround time
– Difficulties in reaching mutual agreement
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ehCare@eastern • Cerner Millennium application for clinical management
– PowerChart
– PharmNet Medication Manager
• Multum AU/NeHTA AMT identifiers
• ehCare@eastern: – Patient information
– Discharge prescribing
– Discharge Summaries
– Pathology & Radiology
– Fluid Balance Charts
– Inpatient prescribing
– Pharmacy review
Release 1
Release 2
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Overview • Drug Interactions
• Allergies
• VTE risk
• Antimicrobials
• Medications
– PINCH
– warfarin
• Reports
• Future Functionality
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Drug interaction settings • State decision – Major:Contraindicated
• Drug interaction data files are supplied by Multum AU
• Drug interactions classified into different levels of severity:
• Considerations: – Level of alert fatigue
– Meaningful interactions
Interaction Severity Example
Major:Contraindicated lithium-naproxen
Major:Major clopideogrel-rabeprazole
Major:Moderate metoprolol-oxycodone
Major:Minor captopril-lercanidipine
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Allergy settings • Cerner system setting
• Functionality and terminology from Multum AU
• Levels:
– Drug or drug class allergy
– Associated drug classes
– Also includes non-drug data, eg. food, environment
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Allergy Alert
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Allergy settings • Cerner system setting – functionality and terminology from
Multum AU
• Levels:
– Drug or drug class allergy
– Associated drug classes
– Also includes non-drug data, eg. food, environment
• Considerations:
– Mandatory fields alignment
– Free text restrictions
– Unknown allergy status
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Venous Thromboembolism risk • State decision
• VTE risk assessment form
• VTE alert
• Considerations: – Link to local policy
– Generalised default message
– Review of status
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VTE Risk Alert
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VTE Risk Form audit
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Antimicrobial Alerts • Local decision – due to organisation specific restricted
antimicrobials
• Alert fires upon ordering conversation if drug is listed as
a restricted antimicrobial:
– Class B
– Class C
• Proceed to iGuidance approval system for EH
• Mandatory fields:
– Approval Number
• Reports
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PINCH • P - potassium
• I - insulin
• N - narcotics
• C - chemotherapy
• H - heparins
• High dose insulin alert
• Caresets
• Special instructions & order
comments
• Additional charting elements
• Opioid patch removal tasks
• Selective orderable
virtualisation
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PINCH • P - potassium
• I - insulin
• N - narcotics
• C - chemotherapy
• H - heparins
• High dose insulin alert
• Caresets & Power Plans
• Selective orderable
virtualisation
• Special instructions & order
comments
• Additional charting elements
• Opioid patch removal tasks
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Order comments, patch removal
& additional charting elements
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Warfarin build
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Warfarin Alerts
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Reports • Allergy KPI report
• VTE risk assessment report
• Freetext reports
• Laboratory values report
• Warfarin reports
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Future Functionality
• Dose Range Checking
• Warfarin Summary Page
• Tall Man lettering
• Multiple anticoagulant alert
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Thank you!