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I think we may be closer to a
solution. For one, we’re thinking we may need to change the PHA
Parameter that prevents the override medications from the dispensing machine to
go to the eMAR. Secondly, we learned from Omnicell yesterday that there’s
a way to set up what they call “Equivalent dose Groups” which would
for example if an order comes over for a 4 mg vial of Dilaudid and the cabinet
only had 2mg vials would automatically convert the order to (2) 2mg vials.
I’m not I’m following the reason behind blocking certain order
types. We do use the Meditech/Omnicell interface. Our cabinets are profiling
cabinets and our ED physicians enter verified orders. Gloria J.
Reid MIS
Assistant Director Phone
(919)938-7758 Pager
(919)871-7045 From: Rea, Joel ( That would work. We have had them
block different order types before. You just loose
the link between the physician order, the medication removed from pyxis, and the
documentation of administration. From:
[EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Hey Joel/Gloria- One other thought is to have your Pyxis
Engineer work on “blocking” specific “orders” from
crossing the interface. There has to be a common hook – Order Type,
SIG, etc. From: Gloria, I feel your
pain. We went live
with EDM back in December, and have yet to go live with POM medication
ordering. The manner in which
to make it work best is to switch the ER pyxis machine over to profile.
If you don’t, you will have POM creating orders, and Pyxis vends creating
orders. If you want to attempt to do the EMAR. This creates issues. We have had big
speed issues with the order sets and ordering that helped the physicians with
their resistance. So we are at a
stalling point. Live with
Trackers, Live with nursing documentation, Live with Hx Med documentation, Live
with the Departure routine, Live with RXM prescription order entry for
discharge. Let me know if
you come up with a solution! Thanks From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] 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. From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On
Behalf Of 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 Phone (919)938-7758 Pager (919)871-7045
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