J Am Pharm Assoc (2003). 2019 May-Jun;59(3):390-397. doi: 10.1016/j.japh.2019.01.019. Epub 2019 Mar 8.
To determine if telepharmacy can be used to collect medication histories on patients admitted in the emergency department (ED) in a large health system.
As part of an effort to address safety concerns, resource limitations, and a decline in medication history completions, a program was developed to use telepharmacy to conduct medication histories on patients admitted in the ED.
The medication history program covers 5 large facilities. It is staffed by 6 full-time pharmacy technicians 7 days a week and is overseen by a pharmacist.
Medication histories are conducted with the use of mobile carts enhanced with videoconferencing equipment allowing technicians to operate from a remote central location. The program allows the technicians to observe multiple EDs at one time, interview patients through videoconferencing, and document completed medication histories in the electronic medical record (EMR). The technicians also transcribe preoperation (pre-op) medication lists for patients being admitted for surgeries.
Medication history completion rates and barriers were assessed. In addition, potential medication errors, medication history accuracy rates for nursing and pharmacy technicians, and a cost analysis of preventable ADEs were explored.
The program, on average, conducts medication histories on 56% to 79% of patients admitted through the ED during hours of operation. In fiscal year 2018, the technicians entered 24,980 medication histories and pre-op lists. A cross-sectional analysis of data collected from December 2016 to March 2017, including 124 patients, revealed 320 potential medication errors among a total of 382 high-risk medications.
Based on the current performance and continued expansion of this novel strategy, use of telepharmacy to obtain medication histories in the ED has led to resource optimization for the remote delivery of a pharmacy service.
确定远程药学服务是否可用于收集大型医疗系统急诊部（ED）入院患者的用药史。
为了解决安全问题、资源限制以及用药史完成率下降的问题，我们开发了一个项目，利用远程药学服务为 ED 入院患者进行用药史采集。
该用药史项目涵盖 5 个大型设施。该项目由 6 名全职药学技术员每周 7 天提供服务，并由一名药剂师监督。
用药史通过配备视频会议设备的移动推车进行，允许技术员在远程中央位置进行操作。该项目使技术员能够同时观察多个 ED，通过视频会议与患者进行访谈，并在电子病历（EMR）中记录完成的用药史。技术员还为接受手术的患者转录术前用药清单。
评估了用药史完成率和障碍。此外，还探讨了潜在的用药错误、护理和药学技术员用药史准确性以及可预防 ADE 的成本分析。
该项目平均在运营期间对 56%至 79%的 ED 入院患者进行用药史采集。在 2018 财年，技术员共录入 24980 份用药史和术前清单。对 2016 年 12 月至 2017 年 3 月期间收集的数据进行的横断面分析，包括 124 名患者，在总共 382 种高危药物中发现了 320 种潜在的用药错误。
根据当前的表现和这种新策略的持续扩展，远程药学服务在 ED 中获取用药史的应用已经实现了远程提供药学服务的资源优化。
