drug file management for multidivisional sites using ehr brian k. johnston dph lieutenant, usphs...
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Drug File Management for Drug File Management for Multidivisional Sites using EHRMultidivisional Sites using EHR
Brian K. Johnston DPhLieutenant, USPHS
Clinical Application CoordinatorChoctaw Nation Health Care Center
Talihina, Oklahoma
Objectives:
Multiple Divisional Drug File vs. One Division Drug File
Formulary Management and Drug File Maintenance
Communication System for Formulary and EHR Changes
Choctaw Nation Health System
145,000 ft² 37 Bed Hospital located in Talihina, OK
6 Satellite Health Clinics Mail Order/Refill Center (opening spring ’07) ~100 Physicians and Mid-Levels Multidivisional Database ran from Talihina’s
Servers (EHR distributed by Citrix)
Multidivisional Drug File
Pros:– Each Pharmacy maintains their own Drug File
(pro & con)– Custom Formularies based on Provider’s
preferences– Open Access for Pharmacist’s Product
Substitutions
Multidivisional Drug File (cont.)
Cons:– Physician Order Entry & EHR– Lots of Rx Editing– Renewing Orders in EHR– Outpatient Medications & Change “link” in
EHR– Maintenance/Design of EHR & Drug File
One Divisional Drug File (Filtered)
Pros:– Standardization of Products– Limited Access to Drug File– Ease of Menu/Quick Order Creation in EHR– Solves Renewal Problem with Multidivisional
Sites
One Divisional Drug File (cont.)
Cons:– Intense Formulary Management– May require an Acquisitioning Technician– Time require to convert all refills to single drug
file– 10-15% of Products Revolve– Rx Editing Required
Formulary Management
Managing Multiple NDC’s– Pharmacy Director determines Generic
substitutions– STOP McKesson’s product substitution– Small price changes DO NOT validate product
switching– Drug File may contain Duplicates, Not EHR
Drug File Maintenance
3 Pharmacists control Drug File
(Staff Pharmacist, Inpatient Director and CAC)
All P&T changes available 1st of following month
Constant design required
Formulary Communication System
P&T determines approved Product & Dosage Forms
Pharmacy Director in coordination with Providers sets the standard strengths available
Acquisitioning Tech sends approved products information to Drug File Guardians
Acquisitioning Tech distributes list of specific items to all facilities
Formulary Communication System (cont.)
Drug File Guardian creates products in RPMS & EHR
New Products available 1st of following month after P&T meeting
All “tweaks” for products are emailed to Drug File Guardians
EHR Design/Development
Standardized View for Providers in EHR “Global” Picture of Patient’s Records Copying of Main Menus in EHR Updating a sub-menu places items in all
divisions P&T Restrictions/Messages instantly seen
by all facilities Citrix Portal Access
