Management Accounting

Byerly, W. (2009). Working with the institutional review board. American Journal of Health-System Pharmacy: AJHP: Official Journal Of The American Society Of Health System Pharmacists, 66(2), 176-184. Retrieved from http://library.kaplan.edu/content.php?pid=150035

Due to the large number of consumers being prescribed multiple medications, and the complexity of managing those medications, it is of a major safety concern that systems are in place for clinicians to reconcile patients medications to resolve any discrepancies in what the patient is using, or should be using, and newly added ones.

However, changing perceptions of prescribers and consumers will be necessary to launch the initiative. The education of providers regarding the therapeutic equivalent and efficacy of generic medications are therapeutic substitutes is very important—prescribers will be the driving force behind adoption of generics over brand-name drugs. The use of e-prescribing provides information regarding cost, formularies and available generics at the fingertips of providers (United States Department of Health and Human Services, 2010).

Over the past decade, virtually every major industry invested heavily in computerization. The heath care industry was no exception to the rise in the use of technology. These technologies are starting to allow health care practitioners to offer faster, and more efficient patient care than ever before. No doubt this is the right direction we expect health care to follow.

The SCHC addressed meaningful use by recording patient demographics, maintaining an active medication lists and incorporating clinical lab test results into the HER, as apart of their meaningful use objectives. For recording patient demographics, they maintained data for accurate billing and ensured that the practice workflow was adjusted to capture all of the necessary patient data. They addressed active medication lists by following the requirements for e-prescribing. Patients were able to review their active medication list during their visit. Changes to the medication list were reviewed with the nurse and adjusted within the EHR system by the doctor. They communicated information for the care coordination process by making test results efficient and safe to access. Physicians were able to make real time decisions when they receive the test results from LabCorp, Quest, and other health

Medication errors are among the most significant cause of patient injury in all types of medical errors (Johnson, Carlson, Tucker, & Willette, n.d). In the nursing profession, medication administration errors occur 34% of the time, second only to physician ordering errors (Gooder, 2011). The introduction of information technology, such as the Bar Code Medication Administration (BCMA), offers new opportunities for reducing medication administration errors. BCMA was developed by the Veteran’s Affairs Medical Center in 1998 to help improve the documentation of medication administration, decrease medication errors and provide

Health information technology or HIT is a huge part of the dashing changes in how medications are prescribed, dispensed, and administered by using technologies electronic devices to share and manage patient information, instead of doing it the old fashion way which was over the phone, having all patients’ records and files on paper, and using the old fax method. Everything is computerized, from managing the

Encourage the use of computer-generated or electronic medication administration records. Plan for the implementation of computerized prescriber order entry systems. Consider the use of machine-readable code (i.e., bar coding) in the medication administration process. Use computerized drug profiling in the pharmacy. Be a demanding customer of pharmacy system software; encourage vendors to incorporate and assist in implementing an adequate standardized set of checks into computerized hospital pharmacy systems (e.g., screening for duplicate drug therapies, patient allergies, potential drug interactions, drug/lab interactions, dose ranges, etc.)”. (Association,

Electronic Health Records (EHRs) are an important component in health care reform, but do they really bring efficiency to the practice? The extent to which practices use EHRs vary from the very basic (entering clinical notes and viewing results) to the intermediate (using e-Prescribing to indicate adverse drug prevention and provide suggestions for alternative drugs) to the advanced use (including lab and radiology order entry with testing guidance, capture of electronic charge, and evidence-based guidelines).

The technology product will be used as onboarding training for new PAS and as refresher on competencies for experienced PAS. The the content will include lessons on all electronic health record platforms and resources that are used in researching medications and compiling the PTA medication list for use in reconciliation. Team member orientation also involves learning the process of completing the PAS standard work. This work includes monitoring patient lists, interviewing patients or other knowledgeable individuals about the medication taken by the patient, verifying the infomation with the pharmacy, primary physician, insurance company, etc., and updating the patient chart to reflect the information. Time management and documentation are also included.

E prescribing can be a part of the EHR in Epic, which would include patient data, and not just prescription information. When e prescriptions are utilized in Epic, the medication is checked for interactions with the patient’s other medications and allergies. Check systems within Epic look for drug-allergy, drug-drug, and how the medication reacts with the disease. In a case study of 17 physicians in an ambulatory clinic conducted by Abramson et al., error rates from prescribing decreased from 35.7 per 100 prescriptions to 12.2 per 100 prescriptions in a year of e-prescribing as reviewed in this study. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 stated that healthcare providers would have access to EHRs to ensure the meaningful use standards per the Centers for Medicaid and Medicare Services (CMS). Meaningful use is attained by increasing the quality of patient outcomes by having access to the medication data, the patient’s history, and diagnosis by the prescriber. Prescribing is safer, when the provider is aware of the patient’s history, current medications, and allergies, therefore better patient outcomes. In the United States, the HITECH Act and the meaningful use standards stated by CMS have increased the use of e-prescribing per Friedman (2009). The CMS made e prescribing a

Electronic Health Records: Understanding and Using Computerized Medical Records, 2nd Edition, by Richard Garlee, Published by Prentice Hall, 2012, Pearson Education, Inc.

Not only does the electronic method of prescribing save time, it has also cut down on the number of accidents caused by the misinterpretation of handwriting. Although now almost obsolete, hand-written prescriptions have been the cause of many medical errors because certain sound-alike or look-alike drugs have, in the past, been incorrectly substituted for one another. A report given by the insurance company, Excellus BlueCross BlueShield disclosed that if all physicians were to begin using electronic-prescription systems, “more than two million adverse reactions or events – ranging from inconsequential to severe – could be avoided each year” (wgrz.com). According to pharmacist and associate director for the Food and Drug Administration’s Office of Drug Safety, Jerry Phillips, “Six-hundred sound-alike or look-alike drug pairs have been identified as possible sources of error since 1992” (nytimes.com). For example, Lamictal, a mood-stabilizing anticonvulsant, is quite similar in spelling to Lamisil, an antifungal drug. Because of these strong similarities, it is not difficult to understand how easy it could be for medical personnel to mistake certain medications. But with e-prescribing, because the prescription is sent directly from the prescriber to the pharmacy, the number of accidents caused by misinterpretation of handwriting has already been

The provision of written medication information given to the patient helps significantly in cases of medication non compliance (McGraw & Drennan 2004). This is because it aids in memory retention and presents patients with access to a reliable source of concise medication information, particularly if the patient needs to be reminded of certain aspects (Gorgos 2006). These written medication information sheets need to be provided in the patients primary, dominant language because it reduces the difficulty and limits barriers to patient understanding (Gorgos 2006).This is important because this intervention aims to increase a patient’s understanding of their medications, and when a patient feels more competent with the use of their medications, reduced

Under the medications tab, the system offers the user with a wide variety of editable selections when entering medications. This would allow the user to feel in control and not limited in their documentation.