Cindy: we went live with 5.6 several weeks ago and had many problems with drug lookups in test once we had done our first formulary load.
We eventually had MT reset them to look identical to 5.4. The C (for combination of generic equiv., trade, generic) was absolutely useless until this was done. We also had problems with the exact lookup for mnemonic working incorrectly in 5.6 as well. As for the formulary: to copy from the "retail" section and create your own mnemonics: Enter the mnemonic for the med you want. When you get to the copy from drug field you need to enter: RT\Repla and then do lookup (where Repla is the first few letters of the TRADE name of the med you are looking for ........ and notice the proper case). Then you can copy the entry you want to your own mnemonic and then do any further edits you want to do. Susan Susan Makara, B.Sc.(Pharm) Coordinator Pharmacy Information Systems Interior Health 2355 Acland Rd., Kelowna, B.C. V1X 7X9 * 250-491-6756 * [EMAIL PROTECTED] Fax: 250-491-6710 "Information for Live: Excellence in Service, Excellence in Information, Excellence in Health" -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of [EMAIL PROTECTED] Sent: Thursday, July 05, 2007 11:57 AM To: Charlie Downs Cc: 'Howes, Lori'; [EMAIL PROTECTED]; [email protected] Subject: Re: [MEDITECH-L] MIX Request PHA - ISMP NOTICE LARGE DOSE AT TOP MIX I think that might be a good idea. I am testing 5.6 and had to have a DTS added because with the user set to "C" things were sorting very badly. Now they are sorting similarly to the way Charlie has described. One thing I thought that I had figured out is that they sort alphabetically by mnemonic, because ours were sorting numerically in correct order by mnemonic as well. However, if you look at Charlie's example, in the Sinequan sort, DOXE10C is listed before DOXE100C and in the DOXEPIN sort DOXE100C is listed before the DOXE10C mnemonic - so even that idea isn't consistent. We also used to put our own short mnemonics into the generic equivalent field - i.e. FUR20, DIG25, to help make look ups easier, but those are slowly being removed because they make the length of the lookup list longer and the duplication are more confusing to look at.. Our users seem to be more comfortable just putting in the first 3 or 4 letters of the trade or generic and hitting [lookup]. Apparently, with one of the upgrade, the formulary service will no longer allow the user to create their own mnemonics for the drugs they pull in from the suspense file. I am afraid this could create problems also, as most of these FSV mnemonics are worthless. So sorting by strength would be something worthwhile to look into. This e-mail message, including its attachments, is for the sole use of the intended recipient(s) and may contain confidential or privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. "Charlie Downs" <[EMAIL PROTECTED]> Sent by: [EMAIL PROTECTED] To "'Howes, Lori'" <[EMAIL PROTECTED]>, <[email protected]> 07/05/2007 04:53 AM cc Subject Re: [MEDITECH-L] MIX Request PHA - ISMP NOTICE LARGE DOSE AT TOP MIX Lori - With the brand name, using the default of C in the access dictionary, here is what I get: 1 SINEQUAN 10 MG CAP Doxepin HCl 10 MG CAP DOXE10C 2 SINEQUAN 100 MG CAP Doxepin HCl 100 MG CAP DOXE100C 3 SINEQUAN 25 MG CAP Doxepin HCl 25 MG CAP DOXE25C 4 SINEQUAN 50 MG CAP Doxepin HCl 50 MG CAP DOXE50C 5 SINEQUAN 75 MG CAP Doxepin HCl 75 MG CAP DOXE75C 6 SINEQUAN ORAL CONC 1 ML Doxepin HCl 10 MG/ML ML DOXEL120 Entering the generic name - I get this: 1 DOXEPIN HCL Doxepin HCl 100 MG CAP DOXE100C 2 DOXEPIN HCL Doxepin HCl 10 MG CAP DOXE10C 3 DOXEPIN HCL Doxepin HCl 25 MG CAP DOXE25C 4 DOXEPIN HCL Doxepin HCl 50 MG CAP DOXE50C 5 DOXEPIN HCL Doxepin HCl 75 MG CAP DOXE75C 6 DOXEPIN HCL Doxepin HCl 10 MG/ML ML DOXEL120 So, it doesn't even seem to be consistent as to which is first between a brand name look-up and a generic name look-up. But I do agree that this is a safety issue and makes sense. Furthermore, if Meditech and the formulary service vendors could get their dose range checking working correctly, it would be less of an issue. I've built a lot of my own dose ranges because the ones with FDB give too many worthless alerts. I believe that the bigger issue here is that a dose range check would have caught this. Charlie Charles Downs PharmD Washington County Hospital 251 E. Antietam Street Hagerstown, MD, 21740 301-790-8904 From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Howes, Lori Sent: Tuesday, July 03, 2007 4:20 PM To: [email protected] Subject: [MEDITECH-L] MIX Request PHA - ISMP NOTICE LARGE DOSE AT TOP MIX Hello, Our Pharmacy department has created a MIX request, and is hoping to get other Meditech PHA users to join us to convince Meditech that this is something we need them to look at. Here is our request; Brief Description/Synopsis of Request When selecting a Drug, we would like the lowest strength to be the first selection. How are you currently handling this now? We have no workaround. What problem will be resolved? Our system has the potential to contribute to a similar error like the one below that happened at another hospital; In an outpatient pharmacy located in a hospital, a prescription for SINEQUAN (doxepin) 100 mg was entered into the computer and dispensed instead of the correct strength of 10 mg. Neither the technician who pulled the 100 mg strength from the shelf nor the verifying pharmacist caught the error. The patient took 500 mg of doxepin daily for one month before the error was corrected. The error was discovered when the prescription was transferred to another pharmacy and the receiving pharmacist expressed concern about the high dosage. Since the error, the patient has been experiencing residual drowsiness and fatigue. The physician is now slowly decreasing the dosage. The pharmacy software system may have played a role in the error. Upon entering Sinequan on the product line, the list of matching results placed Sinequan 100 mg on the first line followed by Sinequan 10 mg. It is believed that the sequential listing of both strengths, with a ten-fold difference, contributed to the selection of the wrong strength, as did the listing of the higher strength first. Proposed Solution Describe in detail how you think the system could be changed, considering Dictionaries Parameters, Input and Output Screens, and Reports. When selecting a Drug, we would like the lowest strength to be the first selection. System Impact Describe why this enhancement is important. How does it improve the MEDITECH system? What impact will it have on users? It will lessen the impact of user error. Although neither is acceptable, user error is inevitable and the thought process is that underdosing is less dangerous than overdosing. Lori Howes Business Systems Analyst - Clinical Support Niagara Health System - Cecil G Shaver Data Centre 541 Glenridge Avenue St. Catharines, ON L2T 4C2 905-378-4647 X44857 Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. ***** CONFIDENTIALITY NOTICE ***** This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate, distribute or copy this e-mail. 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