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Melissa - The new allergy checking feature has two fatal flaws. In fact, I
have a conference call with Meditech and FirstDataBank today where we are
going to try to come up with a solution. The flaws are:
1. During the conversion process (where a patients old generic, class, and
ingredient allergies are mapped to the new allergens), there is a lot of
mapping to what we as pharmacists would consider "inert" ingredients but
which FDB considers "active" ingredients. For instance, in test, I had
entered the pre-mixed Cipro in Dextrose as an allergy. After the mapping, my
test patient suddenly was allergic to approximately 50 different
concentrations of dextrose! There are many other instances of this type of
mapping. The only solution is that FDB needs to only have 1 active
ingredient per drug unless the drug is a combination such as Lotrel,
Zestoretic, etc.
2. Once the conversion is completed, if you have a drug like the Cipro in
Dextrose, even though you delete all of the dextrose concentrations, you
still get flagged for a Dextrose allergy. Another example is Aranesp. If I
enter that as an allergy, if I enter an order for Albumin, I get flagged for
an Albumin allergy because the Aranesp is in Albumin. Below I have pasted
the allergies that my test patient has.
Penicillins
Sulfa (Sulfonamides)
Dextrose 5%-Water (From Cipro in D5W)
Oxycodone (From Percocet)
Acetaminophen (From Percocet)
Titanium
Ciprofloxacin (From Cipro in D5W)
Metronidazole
Darbepoetin Alfa in Albumn Sol (From Aranesp)
As you can see, Dextrose is listed, Titanium is listed (I don't know
where this came from), and Albumin, even though they aren't allergies. Here
again, FDB has failed to narrow this down to the exact drug that the patient
is allergic to. There rationale is that if a patient is for instance
receiving Aranesp, then we don't know if it is the Darbepoetin or the
Albumin that the patient is really allergic to (even though we all have
Albumin in our blood already).
I don't know what will come out of this conference call, but I will
not go live with this until these 2 issues are resolved. Otherwise, I love
the idea of just being able to pick one allergen and everything else happens
behind the scenes. No more worrying about an allergy maybe not flagging
because a drug class is incorrect.
Finally, I hope to convince Meditech that we need to move completely
away from classes as a means of checking duplicates as well. FDB has a
program that also does this behind the scenes, and this should be a logical
step for Meditech to adopt this program instead of relying on classes as a
way of identifying duplicates, since classes are way too general and
supposedly FDB's duplicate checking is more intelligent.
The bottom line is that I would strongly recommend that no one even
attempt this conversion even in test until these issues are resolved. Stick
with what you have until then and wait it out.
Charlie
Charles R. Downs Pharm.D.
Washington County Hospital
251 E. Antietam Street
Hagerstown, MD, 21740
301-790-8904
[EMAIL PROTECTED]
----- Original Message -----
From: "Melissa Wyant" <[EMAIL PROTECTED]>
To: <[email protected]>
Sent: Wednesday, May 03, 2006 11:42 AM
Subject: [MEDITECH-L] PHA/NUR MAGIC Site that has implemented new
AllergyChecking Feature
> All messages should be posted in plain text. HTML will be converted to
> attachments. The meditech-l web site is MTUsers.com
> ======================================
>
> I am looking for a site that has implemented the new Allergy Checking
Feature (available in 5.5 Magic).
>
> If anyone has implemented this and is willing to answer a few questions
please get back to me.
>
> One specific question relates to how the information moves to the PHA
module. Currently our nurses collect Allergy information from the patient
during the NUR admission assessment and the entry is free text into a query.
This query is attached to a Pharmacy CDS that appears during order entry in
PHA and for the Allergy Verification screen in PHA. How is NUR affected by
this change with all allergy information housed in MIS? What does Nursing
use instead of the free text query?
>
> Thanks for any help,
> Melissa
>
> Melissa Wyant
> Pharmacy Application Analyst
> Information Systems
> Holyoke Medical Center
> Phone: 413-534-2842
> Beeper: 413-755-8318
> [EMAIL PROTECTED]
>
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