School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA.
School of Nursing University of Wisconsin-Madison, Madison, WI, USA.
J Am Med Inform Assoc. 2021 Jul 14;28(7):1526-1533. doi: 10.1093/jamia/ocab038.
Medication list discrepancies between outpatient clinics and pharmacies can lead to medication errors. Within the last decade, a new health information technology (IT), CancelRx, emerged to send a medication cancellation message from the clinic's electronic health record (EHR) to the outpatient pharmacy's software. The objective of this study was to measure the impact of CancelRx on reducing medication discrepancies between the EHR and pharmacy dispensing software.
CancelRx was implemented in October 2017 at an academic health system. For 12 months prior, and 12 months after CancelRx implementation, data were collected on discontinued medications in the health system's EHR and whether those prescriptions were successfully discontinued in the pharmacy's dispensing software. An interrupted time series analysis was conducted to model the occurrence of prescriptions successfully discontinued over time.
There was an immediate (lag = 0), significant (P < 0.001), and sustained (post-implementation slope 0.02) increase in the proportion of successful medication discontinuations after CancelRx implementation (from 34% to 93%). CancelRx had variable impact based on whether the clinic was primary care (71.4% change prepost) or specialty care (53.9% change prepost). CancelRx reduced the time between when a medication was discontinued in the clinic EHR and pharmacy dispensing software.
CancelRx automated a manual process and illustrated the role for health IT in communicating medication discontinuations between clinics and pharmacies. Overall, CancelRx had a marked benefit on medication list discrepancies and illustrated how health IT can be used across different settings to improve patient care.
门诊和药房之间的用药清单差异可能导致用药错误。在过去十年中,出现了一种新的医疗信息技术(IT),名为 CancelRx,可以从诊所的电子健康记录(EHR)向门诊药房的软件发送用药取消信息。本研究的目的是衡量 CancelRx 在减少 EHR 和药房配药软件之间用药差异方面的影响。
CancelRx 于 2017 年 10 月在一家学术健康系统中实施。在实施 CancelRx 之前的 12 个月和之后的 12 个月,收集了系统 EHR 中停用药物的数据,以及这些处方是否在药房的配药软件中成功停用。进行了中断时间序列分析来模拟随着时间推移成功停用处方的发生情况。
在实施 CancelRx 后,立即(滞后=0)、显著(P<0.001)和持续(实施后斜率 0.02)增加了成功停药的比例(从 34%增加到 93%)。根据诊所是初级保健(71.4%的变化)还是专科保健(53.9%的变化),CancelRx 的影响不同。CancelRx 缩短了药物在诊所 EHR 和药房配药软件中停用的时间。
CancelRx 自动化了一个手动过程,说明了医疗信息技术在诊所和药房之间沟通用药停止方面的作用。总体而言,CancelRx 对用药清单差异有显著的益处,并说明了医疗信息技术如何可以在不同的环境中使用,以改善患者的护理。