tag:blogger.com,1999:blog-8434050931789572015.post5834341466656392643..comments2023-08-30T22:42:22.226-04:00Comments on DirkMD - CMIO Perspective: Lack of Informatics support in ARRA/HITECHDirk Stanley, MD, MPHhttp://www.blogger.com/profile/09568427937893548660noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-8434050931789572015.post-22702590670235348452009-11-30T00:17:32.903-05:002009-11-30T00:17:32.903-05:00Oh, and as for steroid tapers and IV fluids :
Fr...Oh, and as for steroid tapers and IV fluids : <br /><br />Free text brings its own problems.<br /><br />If there answer is going to be either :<br />1. Docs properly ordering tapers/IV fluids OR<br />2. Order sets to address tapers/IV fluids.<br /><br />... then this education is another thing the administration is going to have to tackle.<br /><br />(You'll notice the recurring themes : Increased education, good policy mechanism - These are needed for an EMR to succeed, no matter which system you buy.)Dirk Stanley, MD, MPHhttps://www.blogger.com/profile/09568427937893548660noreply@blogger.comtag:blogger.com,1999:blog-8434050931789572015.post-15776745392786096282009-11-30T00:14:25.764-05:002009-11-30T00:14:25.764-05:00All great points -
What you're getting at is ...All great points -<br /><br />What you're getting at is the need for new clinical policies to address these issues.<br /><br />You're right : Expecting docs to do this 100% correctly at day one is just unrealistic. But asking a pharmacist how often they see "BID" and "q12h" interchanged is a good way of getting a sense of how big a problem this is.<br /><br />This is part of the culture shift that an EMR brings to doctors. If your administration isn't ready for the culture shift, and don't support the informatics effort, then your transition to an EMR is going to be rocky, no matter which system you buy. (In my humble opinion.) :)Dirk Stanley, MD, MPHhttps://www.blogger.com/profile/09568427937893548660noreply@blogger.comtag:blogger.com,1999:blog-8434050931789572015.post-78989823910957725042009-11-28T23:09:32.700-05:002009-11-28T23:09:32.700-05:001. Other than preop antibiotics why shouldn't ...1. Other than preop antibiotics why shouldn't all inpatient doses of antibiotics start now? <br />2. How can you track the frequency of this error - relying on occurrence reporting is notoriously weak; by making all doses (by policy) changed by nursing and pharmacy to include a now, you could report on any drug in the class of abx if not given with a now. <br />3. It is unrealistic to expect that physicians will suddenly start ordering correctly 100% of the time. All med orders should be verified and an explicit understanding of what pharmacy will routinely change and what is considered an error worthy of remedial action needs to be communicated regularly.<br />4. Steroid tapers and antiepilepsy drugs that vary in dose during the day are difficult to order electronically as a SINGLE order; using order sets for these is counterintuitive. Should these be 'free text orders' or should they be routinely repaired by the pharmacists? <br />5. IV fluid orders with additives are also difficult to order - same questionsrvaughnMDhttps://www.blogger.com/profile/09958728840526322073noreply@blogger.com