I have found that this method works okay:
On page 7 of the drug dictionary is a prompt that says "restricted". This is
the prompt to use if you enter a non-formulary drug into your drug database.
There are quite a few bits of confusion about terminology and the most
misunderstood words are "FORMULARY" and "Non-formulary".
When you say Formulary to Meditech, they will think of your drug data base or
the formulary service provider. They do not think of "NON-Formulary" as being
a drug restricted for use in the hospital by the PT committee in favor of using
another drug.
The "NON-FORMULARY" routine in the PHA dictionaries, where you can enter
"non-formulary" meds (there are only a couple of pages here) are for meds that
are
not in the regular drug dictionary that someone might want to enter "on the
fly". Due to the incredible complexity of the drug dictionary itself, we do not
use this particular function, although I have taught a couple of people to use
it just in case I am not around and they really need to have that drug added
somewhere that it will flag allergies, etc.
What I usually do if I have a non-formulary drug which the MD has ordered and
filled out a non-formulary request for - is that I
enter the drug into the regular drug dictionary and set the restrict prompt on
page 7 to YES. I have a MED rule that flags the user that "THIS IS A
NON-FORMULARY DRUG and REQUIRES an NF request". I also have a little notation
in the formulary field on line 1 that says NF.
If someone needs to dispense a new drug that is not in the dictionary and there
is no one to enter the drug into the dictionary, we use a dummy drug
called NEWDRUG, or NFDRUG -
they 0 dose the order and enter the dose/route and frequency in the o dose
field. They enter the name of the drug in the sig field preceded by a "."
(The . allows for freetext)
They then put all the info on the desk for the drug to be entered. And I also
will do a search for the drug NEWDRUG to make sure no one has done
anything odd with it. The only problem is that you don't get allergy and
interaction checking. To get that, they will enter a FAKE order for a similar
drug and not file it to see if anything pops up, or they will use the
allergy/interaction checking routine and use a similar drug entity. Or they can
look
it up in a booK.
Good luck. Cindy
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<[EMAIL PROTECTED]>
Sent by: [email protected]
To
"'Adnan
Hamid'" <[EMAIL PROTECTED]>, "'MEDITECH-L'" <[email protected]>
02/20/2007 05:17 PM
cc
Subject
Please respond to RE:
[SPAM] [MEDITECH-L] PHA: Desiging Drug Database
[EMAIL PROTECTED]
Hi Adnan-
Not exactly sure what is meant by "...2 separate databases..." - I'm
assuming that means utilizing the "Non-Formulary Dictionary". For many
reasons I would not recommend utilizing that particular dictionary, mainly
for maintenance issues. The option of a unique mnemonic is problematic as
well (example, NF-XXXXX) - I would look at utilizing a separate Drug Type
for these meds. Your flexibility for dictionary lookup, report output, PHA
Rules for decision support on order entry, etc. are all good reasons. I
firmly believe that the Non-Formulary section in a Pharmacy should be very
small, and think of the issue when something goes from NF to
Formulary...what then? In this example, the Drug Type is changed...
Best of luck - Kevin.
Kevin McConnell, PharmD.
Clinical Consultant
(713)480-6810
[EMAIL PROTECTED]
www.RPhInformatics.com
-----Original Message-----
From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf Of
Adnan Hamid
Sent: Wednesday, February 14, 2007 1:44 AM
To: MEDITECH-L
Subject: [SPAM] [MEDITECH-L] PHA: Desiging Drug Database
We are in the beginning of designing our dictionaries. One item that
has come up is how to design the drug database. In particular, it is
how to assign non formulary drugs. We are being given two choices
from Meditech:
1. Have two separate data bases- one for formulary items and one
for non-formulary items.
2. Utilize the formulary data base, but have some designation
built into the drug mnemonic to designate a non formulary drug.
Each has its pluses and minuses. I prefer option #1, because it will
allow additional report capability and make drug look up easier.
How have others handled this?
--
Adnan E. Hamid MBA, CPHIMS
I.S. Manager, Applications/Project
Henry Mayo Newhall Memorial Hospital
23845 McBean Parkway
Valencia, CA 91355
Email: [EMAIL PROTECTED]
Phone: 661-253-8375
Fax: 661-253-8327
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