It was pointed out in the article, and I should have mentioned it, the the reason the counts were high is because the system was able to identify them.
It also mentioned that drug interactions were checked, although the interaction checking was not described inthe same detail as you described it. The article said that other things, like making sure a checks of serum potassium were ordered for the future for patients started on Lasix, were not implemented. It was not blaming the records system for causing the high numbers, but it was indicting it for not having better decision support to prevent the high numbers. As I understand it, some of that sort of decision support is implemented but, as you can imagine, the amount of decision support that is available on a system could vary very widely in type, amount and quality from system to system. Readily available, targeted order sets were felt to be one way to cut down on these problems. On Sunday 29 May 2005 01:26 am, Chris Richardson wrote: > Nancy; > > There is drug/drug, alergy, and drug/food interaction associated with > orders (OR*). At the hospitals, drug orders are written by physicians > (bolstered by CPRS) and must be reviewed and signed by a pharmacist. Then > the point of care interface, Bar Code Medication Administration (BCMA) > system (PSB*) also is another check to make sure that the proper drug is > given in the proper dose at the proper time to the proper patient. The > nurse is the final check on the delivery of the drug and records the result > of the administration (dose given/patient refused/etc). > > Please remember that the increased counts are a measure of looking for > these errors as well as having automated methods of the recording of the > dispensing of the drugs. The actual count of drug errors in hospitals > where these automated methods are not used may never be known. If drug > delivery cannot be measured in a meaningful way, no policy change is likely > to have much effect. > > ----- Original Message ----- > From: "Nancy Anthracite" <[EMAIL PROTECTED]> > To: <[email protected]> > Sent: Saturday, May 28, 2005 9:27 PM > Subject: [Hardhats-members] Archives of Internal Medicine Article > > > The May 23rd issue of the Archives of Internal Medicine had an article > > about > > > the high rates of adverse drug related events noted in a VA Hospital. The > > lack of decision support for selection, dosing and monitoring was cited > > as > > a > > > deficiency in the EMR that if corrected, might prevent some of these > > problems. The presence of drug interaction checking was mentioned. > > > > The abstract is here. > > http://archinte.ama-assn.org/cgi/content/abstract/165/10/1111 > > > > It is my understanding that there is some decision support already > > present > > in > > > VistA but it is less than the ideal according to this article > > > > I doubt any record system out there is ideal, but I can see this as > > something > > > that will be cited as a reason not to adopt VistA . I bring it to your > > attention so you will not be surprised by this also so that we can work > > toward adding more decision support to VistA with the help of the medical > > community as it grows. > > > > I am hoping that the release of VistA Office and the web site that will > > come > > > with it will be a place for the VIstA users to debate and contribute > > specific decision support suggestions as well as templates, clinical > > reminders, etc. I hope that users within the VA will also be willing to > > contribute and that this will lead to improvements in VistA for > > everyone's benefit. > > > > > > -- > > Nancy Anthracite > > > > > > ------------------------------------------------------- > > This SF.Net email is sponsored by Yahoo. > > Introducing Yahoo! Search Developer Network - Create apps using Yahoo! > > Search APIs Find out how you can build Yahoo! directly into your own > > Applications - visit > > http://developer.yahoo.net/?fr=offad-ysdn-ostg-q22005 > > _______________________________________________ > > Hardhats-members mailing list > > [email protected] > > https://lists.sourceforge.net/lists/listinfo/hardhats-members > > ------------------------------------------------------- > This SF.Net email is sponsored by Yahoo. > Introducing Yahoo! Search Developer Network - Create apps using Yahoo! > Search APIs Find out how you can build Yahoo! directly into your own > Applications - visit http://developer.yahoo.net/?fr=offad-ysdn-ostg-q22005 > _______________________________________________ > Hardhats-members mailing list > [email protected] > https://lists.sourceforge.net/lists/listinfo/hardhats-members -- Nancy Anthracite ------------------------------------------------------- This SF.Net email is sponsored by Yahoo. Introducing Yahoo! Search Developer Network - Create apps using Yahoo! Search APIs Find out how you can build Yahoo! directly into your own Applications - visit http://developer.yahoo.net/?fr=offad-ysdn-ostg-q22005 _______________________________________________ Hardhats-members mailing list [email protected] https://lists.sourceforge.net/lists/listinfo/hardhats-members
