Moving from a PharmNet™ Build to an EHR Medication Process
By Kathleen Schumann

Many facilities have implemented individual Cerner solutions based on application replacement needs. Often the workflow and build is based on a single department (pharmacy, lab, radiology) rather than future workflow with an integrated Electronic Health Record (EHR). This strategy, while often necessary due to sun-setting applications, often requires rebuild when an EHR is implemented. This is often the case when PharmNet is implemented to replace another pharmacy information system. When Cerner Millennium Computerized Physician Order Entry (CPOE) Enhance Medication Reconciliation and ePrescribing are brought into the picture, several areas need to be reviewed or reconsidered for providers to manage medications for the progression of the patient stay, with the least obstacles.

Audits and queries are available to assess potential issues with completing the full medication administration or reconciliation processes. A review of units of measure medication, forms, missing, duplicate or mismatched CKIs, C-Dispensable synonyms, M and N Miscellaneous product synonyms, DCP synonyms, obsolete synonyms, PRN reasons, and frequency of Multum updates should be done to evaluate potential work flow issues. Variances in any of the above areas can cause disruptions in the medication process during a patient stay and can create frustration or potential patient safety issues.

Stand-alone PharmNet builds and implementation were done with good reasons relating to patient safety and efficient workflow based on paper forms for the medication process. Often the solution for these organizations was to create additional synonyms to assist in clarifying orders. These additional synonyms can create hardships in the conversion from historical to inpatient to discharge prescriptions and often require new strategies. Careful acknowledgement of their efforts must be made when communicating potential restructuring of the tables. A focus on patient safety and multidisciplinary workflow should be highlighted on all communication and work efforts. A team consisting of physicians, pharmacists, nursing, and other licensed providers will need to review options and determine how to best address issues and resolve gaps to efficient CPOE, medication reconciliation, and ePrescribing. The ease of converting medications, through a patient stay, will aid in maintaining safe patient care and assist with CPOE adoption. The group will need to determine how to best address medications whose primary name will not always align with the written orders utilized prior to CPOE.

The collaborative efforts required between the Power Orders and PharmNet teams cannot be underestimated. Communication strategies must also be developed to handle ongoing medication product and synonym changes with Multum updates. Providers that utilize “favorites” folders may find many of their favorite meds are no longer accessible and need notice of changes and alternative selections. These groups must be present for all CPOE steering efforts and be willing to demonstrate the “give and take” required for a successful implementation and continued development.

For more information about PharmNet and CPOE, or other Cerner solutions offered by VCS, please contact us at 610.444.1233, vcs@getvitalized.com, or visit www.getvitalized.com.