As requested, here are the responses I received to my question on
partial implementation of RXM for med reconcilation.
 
Roger
 
We don't have partial RXM, we have the whole module, but the
documentation is the same. We have used this as our Medication
Reconciliation for over 1.5 years. It was a difficult process to get
started because you have no Data Base to start with so each patient
needs to have the medications entered. It is easy to enter the
medications with or without strings already built. When we went Live
with this we had very few drug strings built, but the nurses did fine. 

The hard part is deciding how to manage the list of medications. We did
it the hard way. We loaded the drugs from our formulary service and then
took the hard road to inactivating all of the unnecessary drugs. 

It has been recommended to load the formulary load and then have
Meditech Inactive all of the drugs. At that point you would activate the
drugs you want. We have built strings for the top 250 drugs. This task
was given to the Pharmacist to do. I helped in the beginning providing
them with a list of everything I did so they could check the strings.
The Pharmacist now use the RXM list to reconcile medications ordered in
house with the home meds. 

I think the best part of the RXM is the Allergies. When nurses enter the
allergies they are coded allow for interaction checking even when a
Pharmacist is not on duty. It is a good patient safety issue under
better control.

Let me know if you have any questions,

Roberta Laurimore, RN

Clinical Analyst

Culpeper Regional Hospital

540-829-4359

 
As more of a bridge, we use Iatrics PDI. It has a direct link to PHA
database. We have med recon/home meds as part of intake process using
NUR. We also have a goodly number of physicians using PDI to confirm
medications on discharge. Not a trivial project..From the above, you
should have determined that 'take too long' isn't an exceptable excuse.
Buy in (grudgingly) of medical staff is crucial. 
 
We also have RXM in the ambulatory setting. Another very non-trivial
undertaking. 
 
 

Cliff Vaux, RN, MS
Office 207.664.5367


Hey Roger-

I have worked with a few sites (both Magic and CS) on the partial RXM
implementation, and the Drug Dictionary in RXM is the big setup.
Theoretically, Mrs. Smith can walk into your ED with a bag of meds on
almost anything...including homeopathic meds.  So most sites see the
need for loading the entire FSV file - about 75,000 lines items.  Once
you inactive the Band-Aids, syringes, catheters, etc, you end up with
about 35,000.  Then the fun begins - you only need one Furosemide 40mg,
not 16.  Removing all of the "duplicates" and ensuring the one you leave
is the one in your PHA Dictionary - and then there's order strings.  I'd
recommend looking at buying them from your FSV...all in all, probably
about 200 man-hours of work.  Then there's the reports...I think Herb B.
and I are both going to show a few examples at the PHA Show-n-Tell this
year at International MUSE.

 

I think it's worth the time spent - Nusring likes it; Physicians like
it; and Pharmacy likes it too.

 

Be well - Kevin.

 Kevin McConnell, PharmD.

Clinical Consultant

(713)480-6810

[EMAIL PROTECTED]

 

 
 


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