Gary - Are you using your own dose ranges or those provided by a formulary service? If they are FSV dose ranges, you might just want to forget it and build your own. We have FDB and there are problems with some of their dose ranges and also with the way Meditech uses them. You can turn off prn checking as far as daily dose, but this still doesn't eliminate the problems, just some of them. And with the prn's, there is no reason that the dose checking doesn't know that qid prn means the same as 4 times daily and check the total daily dose based on that. Loading doses present another problem; Tygacil has a 100 mg loading dose, then is dosed q12h. The problem is that Meditech has no way to tag an order as a loading dose on order entry, so if you have 100 mg as your max dose, then you could in error enter 100 mg q12h. Meditech needs to add a field to all orders for loading dose, default it to N, but allow the user to change it to Y. Also, many of the doses are based on disease state; we don't have the time to enter the disease states and until this happens behind the scenes based on coding, it is worthless. The renal dosing is a joke; you can get a general warning if the creatinine clearance is below a certain point, but it doesn't tell you how to dose based on the creatinine clearance. Zosyn for instance is renally adjusted for ClCr <40, but it is also dosed differently for ClCr <20, and differently for hemodialysis patients. The lifetime dose only works if you have the oncology module; there is nothing that would warn you if a patient is on 2 acetaminophen products and the combined daily dose is <3 or 4 grams, depending upon which one you chose. I can't see Meditech fixing these problems anytime soon as it is not where it should be on their priority list.
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 Gary Hall Sent: Wednesday, July 11, 2007 10:19 PM To: Cindi Lockhart; [EMAIL PROTECTED]; [email protected] Subject: Re: [MEDITECH-L] Is anyone using Dose Range Checking? I'm very interested in any replies. We are coming up with PHA (Magic 5.5 SR2) and having a devil of a time with dose-range checking. Meditech is working with us, but we've been a couple months on this issue. They installed a wide range of DTSs this last week, and the examples that were giving us grief (overalerting) have gone away, but I need to run a bevy of tests to see if it's really tamed. It seems that many of the loading and single-dose range checks failed to recognize that the total accumulation of a med was not the first or a single dose; we were getting warnings that the eight planned doses (or whatever) exceeded the total loading or single dose of 1. Not very useful, and certainly slows down order entry. I'm interested in the replies of the experienced, and Cindi, I'll let you know whether Meditech has indeed brought us to a point of tolerability. All I have to do is let my pharmacist in to enter some test orders and he's magic about finding more dose range problems... Gary Hall Clinical Applications Specialist Estes Park Medical Center Information Systems Department 970-577-4443 _____ From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Cindi Lockhart Sent: Wednesday, July 11, 2007 3:15 PM To: [EMAIL PROTECTED]; [email protected] Subject: [MEDITECH-L] Is anyone using Dose Range Checking? We were wondering if there are any sites out there that are live with POM and PHA who utilize Dose Range Checking (either supplied by FSV or customized)? We are C/S 5.5.2, and very interested in making this work for us without OVERALERTING our providers. Thanks! Cindi Lockhart IS Application Specialist PHA/POM/EMR Citizen's Memorial Healthcare [EMAIL PROTECTED] 417-328-6617 The information contained in this e-mail, including any attachments,is legally privileged and confidential. If you are not the intended recipient, you are hereby notified that any use or dissemination of this message is strictly prohibited. If you have received this message in error, please immediately notify us by telephone 417-328-6526 and delete this message from your system. Even though this e-mail and any attachments are believed to be free of any virus or other defect that might affect any computer system into which it is received and opened, it is the responsibility of the recipient to ensure that it is virus free, and no responsibility is accepted by Citizens Memorial Hospital for any loss or damage arising in any way from its use. The information contained in this message may be privileged and confidential and protected from disclosure. If the reader of this message is not the intended recipient, or an employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please notify the sender of this communication immediately. ***** 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. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system.
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