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Hey Gloria-

I see a lot of potential issue with what I’m reading – first, I’m assuming the orders are crossing as unverified because the Pharmacy would change to the appropriate drug.  Also, do you have the Meditech/Omnicell interface running?  Sounds like the unverified order is crossing to your eMAR and it won’t to the cabinet.  And why is everything orderable in POM if it’s not available?

 

Worst case scenario, a POM Rule with your cabinet inventory in a macro – you’d have to edit the PHA.RX.rx.file macro and then maintain it moving forward as the inventory changed in the cabinet.  Then compare the “ordered drug” to the macro list, instead of a favorite list…which I can’t see maintaining with any accuracy if you have several physicians.

 

I think a lot of sites won’t have an issue like this because for one, I don’t think the eMAR is used in outpatient locations as much as the inpatient ones – but I think most folks still have their ER cabinets set to “non-profile” so they’re not overriding the meds.

 

Best of luck – Kevin.

 

 

 

 

 

Kevin McConnell, PharmD.

Clinical Consultant

(713)480-6810

[EMAIL PROTECTED]

www.RPhInformatics.com


From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Reid, Gloria
Sent: Friday, October 06, 2006 8:50 AM
To: [EMAIL PROTECTED]
Cc: ED Meditech Core Team
Subject: [MEDITECH-L] POM Medication Ordering w/Pharmacy Dispensing Machines

 

Hi!  We are C/S 5.5 SR2.  We went LIVE with EDM back in April and brought up the POM component in July.  Only a day into our go LIVE with POM, we quickly decided to put a halt to the medication ordering through POM.  We were having too many problems.  Since then, we’ve done many controlled parallel runs and have identified the problems.  All problems stem from this one issue.  Currently, we have all drugs in PHA set to be orderable through POM.  The problem is that not all of these drugs are stocked in Omnicell as they are ordered.  So, we’ve had lots of problems with because of the way the medication is ordered, the order not being sent to Omnicell.  In most cases the medication is, however, stocked in Omnicell.  So, then the nurse ends up doing an override to dispense the medication from Omnicell which creates a separate order.  Then we end up with duplicate orders on the MAR.  For example, in the ER, our Omnicell has Dilaudid 2mg vials.  If the physician orders Dilaudid 4mg, the system would not send the order to the Omnicell Cabinet because it would think the med wasn’t stocked in the cabinet since we do actually have 4mg vial.  So, rather than it knowing to use the 2mg vial and just dispense 2 vials, it considers the drug to be dispensed from the MAIN inventory from Pharmacy.  I’m just wondering if there’s something we can do differently in the way the drugs are defined in PHA to help with this problem.  Any suggestions?  Have any of you experienced this problem?  Right now, we’re in the process of building a Favorite list for each physician of the medications that are stocked in their ER cabinet to hopefully resolve this problem.  This is very time consuming though because the only way to set this up is to emulate each physician and mimic medication ordering.  There’s also no copy feature for Favorites in POM.  So, this would have to be done for each physician.  We’re only working in the ED right now.  So, we’re certainly hoping we don’t have to go this route when we bring up POM hospital wide.  We’d really appreciate in feedback anyone might have.

 

Gloria J. Reid

MIS Assistant Director

Johnston Memorial Hospital

Phone (919)938-7758

Pager (919)871-7045

 


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