Department of Health Management and Informatics, University of Missouri Informatics Institute, and Center for Health Care Quality, University of Missouri, Columbia, MO 65212, USA.
Am J Health Syst Pharm. 2010 Dec 1;67(23):2052-7. doi: 10.2146/ajhp090643.
Purpose The implementation of a telepharmacy service to provide round-the-clock medication order review by pharmacists is described. Summary Seven critical access hospitals (CAHs) worked collaboratively as part of a network of hospitals implementing the same electronic health record (EHR), computerized prescriber-order-entry (CPOE) system, and pharmacy information system to serve as the health information technology (HIT) backbone supporting round-the-clock medication order review by pharmacists. Collaboration permitted standardization of workflow policies and procedures. Through the HIT backbone, both onsite and remote pharmacists were given access to the medication orders, the pharmacy information system, and other patient-specific clinical data in patients' EHRs. Orders are typically reviewed within 60 minutes of when they are entered into the system. The reviewing pharmacists have remote access to the EHRs in each CAH. After completing the clinical review, the pharmacist selects the appropriate medication to dispense from the CAH's formulary. If the medication order is not made using the CPOE system, the order is scanned into a document and sent via e-mail to remote pharmacists. The pharmacist enters the necessary information into the EHR and pharmacy information system. The medication order review process from this point forward is identical to that used for medications ordered via CPOE. The new medication order is then entered into the EHR, and the CAH nurse can proceed with the order. Conclusion The implementation of a telepharmacy model in a multihospital health system increased access to pharmacy services, allowing for round-the-clock medication order review by pharmacists.
描述实施远程药学服务的情况，以实现药师 24 小时全天候的药物医嘱审核。
七家基层医疗机构（CAH）作为使用相同电子病历（EHR）、计算机化医嘱录入系统（CPOE）和药房信息系统的医院网络的一部分，共同合作，为 24 小时的药物医嘱审核提供药学服务，作为支持药师 24 小时药物医嘱审核的医疗信息技术（HIT）的骨干。协作允许标准化的工作流程政策和程序。通过 HIT 骨干，现场和远程药师都可以访问药物医嘱、药房信息系统和患者电子病历中的其他患者特定临床数据。医嘱通常在录入系统后 60 分钟内进行审核。审核药师可以远程访问每个 CAH 的 EHR。完成临床审核后，药师从 CAH 的处方集选择合适的药物进行配药。如果药物医嘱不是通过 CPOE 系统录入的，则将医嘱扫描到文档中，并通过电子邮件发送给远程药师。药师将必要的信息输入 EHR 和药房信息系统。从这一点开始，药物医嘱审核过程与通过 CPOE 录入的药物医嘱相同。新的药物医嘱随后输入 EHR，CAH 护士可以继续执行医嘱。
在多医院医疗系统中实施远程药学模式增加了对药学服务的获取途径，实现了药师 24 小时全天候的药物医嘱审核。
