Hi all - THIS IS REALLY BIZARRE. Our nurses in the ED enter allergies by
ingredient allergies. Since Medispan codes all ampicillins, dicloxacillins,
amoxicillins etc by penicillin, this was problematic, as the nurse would not
enter penicillin. I made them the ingredients ampicillin and amoxicillin, but
only attached them to ampicillin and amoxicillin, but I did attach them in the
generic for penicillin in the generic dictionary.
If the nurse chooses to enter the ingredient ampicillin - which I made - they
get a pop-up box to check off an appropriate class, generic or other
ingredient.
This only seems to happen with ingredients that I made as opposed to
ingredients that cam form MEDISPAN. (We are Magic 5.5 vs1)
You do not get this pop-up box at all in pharmacy if you enter the allergy by
the ingredient. Only if you enter an allergy by generic.
(Either in Magic workstation 3 or in the NUI workstation 4).
Also, at one time, I had issues with orders being entered for acteaminophen
flagging on patients with codeine allergies. I thought it was because
acetaminophen was in the ingredients for Acetaminophen and codeine because the
generic codeine was often not entered. This led me to believe that if I place
an ingredient in the generic that I wanted to flag against, it would work. So I
put ampicillin into the penicillin generics - as I said above - in RXM I got
the pop up box but not in PHA.
I have yet another oddity. I thought that once upon a time if I had associated
generics with a particular generic - say that I associated the generic for
promethazine to the generic for promethazine and codeine the patient had
codeine ingredient listed as an ingredient allergy, whenever I entered
promethazine
plain as an order, I would get flagged with the codeine allergy. This may have
been a "bug" that was subsequently fixed. Or it may have been something that
once worked in PHA, didn't work in RXM and now works nowhere.
I have also found out something else that really bothers me. Suppose you have
pulled a drug into the RXM drug dictionary from the suspense file and that
drug has a mnemonic for a generic that is active in the PHA dictionary and that
generic has all the appropriate allergy ingredients in it. You even
associated the appropriate generics with that generic. Someone enters the
allergies by ingredient. Then someone enters an order in RXM for a drug that
should elicit an allergy flag against that ingredient. UNLESS THE DRUG IS ALSO
LIVE IN THE PHA DICTIONARY, the allergy won't flag against the ingredient
entered as the allergy.
It will only flag if the generic for the drug has been entered as an allergy if
the drug in RXM is not active in the PHA dictionary. I swear that it used
to work
with ingredient.
I find this all very confusing now as I have been trying to explain how
allergies work to people who are going to have to train others to enter
allergies in
RXM
and things don't work either the way the did, or they don't work the same
across modules. Or something else funny happens. I feel like my mind is
constantly
being played with. I hope that someone can come up with some answers as I do
not think that Medispan will have the answers we need.
Thanks Cindy
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"Griffin, Paul" <[EMAIL PROTECTED]>
Sent by: [EMAIL PROTECTED]
To
"Carole
Weinstein" <[EMAIL PROTECTED]>, <[email protected]>,
10/27/2006 12:31 PM <[EMAIL
PROTECTED]>
cc
Subject
RE:
[MEDITECH-L] Medi-Span Problem
Hi all,
I received this "non-response" from Medi-Span today (after two weeks of
waiting):
Paul,
My apologies for the delay in my turn around response to you. I sent
this to the Aller-chek Product Editor. He reviewed your screen prints
and Aller-chek data within our maintenenace system and confirmed:
Maintenance system data reviewed in AC and there is no linkage between
acetaminophen or aspirin with the related ingredient allergies noted in
the
user screen prints. Aspirin is set up with a number of cross-reactor
classes,
none of which are Codeine, Dimenhydrinate, or Diphenhydramine.
Acetaminophen
is not set up with any cross-reactors in the AC maintenance system.
Could
their system be deriving this information from some combination products
or
other source within their system? It does not appear to be data-related.
Does anyone using Medi-Span NOT have this problem? I'm looking for some
common denominator here. I'm not filing my latest update from them until
I get this mess cleared up. We are MG 5.4 SR2.
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Carole Weinstein
Sent: Tuesday, October 24, 2006 12:01 PM
To: Griffin, Paul; [email protected]; [EMAIL PROTECTED]
Subject: RE: [MEDITECH-L] Medi-Span Problem
Hi all,
This is the answer from MT from my task today:
I have just spoken with another specialist that is in contact with
Medi-Span. These DTSs do not fix this issue. As far as the allergy
information, please know that the system uses the information in the
drug dictionary for allergy checking (this would be the information in
the "Ingredient Allergies" field on page 5 of the Drug Dictionary. The
related ingredients associated in the Generic Name dictionary are used
only as a reference when coding a patient with a genericallergy to ask
the user "Do you want to code the patient with these related ingredient
allergies as well?" Also, we are in contact with Medi-Span about this
issue. The specialist at Medi-Span is out for the day but will return
tomorrow. I will give you an update as soon as I have more information
from Medi-Span regarding this issue.
>>> "Lehl, Jim" <[EMAIL PROTECTED]> 10/23/06 10:29AM >>>
Please respond to L.
Thanks for alerting the List Paul. We checked the results or are recent
Medispan FSV update and have found the same problems you mentioned.
We've only opened an issue with Meditech thus far. We've yet to asses
what our corrective actions -- because of patient safety, it doesn't
seem like something we can wait for either Meditech or Medispan to
resolve with programming.......
Jim
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Griffin, Paul
Sent: Thursday, October 19, 2006 7:11 AM
To: [email protected]
Subject: [MEDITECH-L] Medi-Span Problem
Hi all,
Recently I have experienced a problem with our latest FSV
(Medi-Span) File. Quite a few Generic Names have the Related Ingredient
Allergy fields populated by Medi-Span with incorrect Related
Ingredients. For example, Acetaminophen has Docusate, Morphine,
Ipratroprium, Fish-Derived Products, Guaifenesin, Codeine, among others.
I reported this to MEDITECH and they asked me to contact
Medi-Span. I have not received any responses, despite multiple
calls/emails. In any case, I called MEDITECH back a few days later and
my Apps Specialist now states that three more of her sites are
experiencing the same problem.
Is anyone out there in L-Land noticed this issue? Thanks and
have a great day.
Paul E. Griffin R.Ph.
Emerson Hospital
(978) 287-3769
[EMAIL PROTECTED]
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