Stephanie Chau, ehCare Clinical Application Pharmacist, Eastern Health - Decision Support Designs...
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Transcript of Stephanie Chau, ehCare Clinical Application Pharmacist, Eastern Health - Decision Support Designs...
Members of Eastern Health: Angliss Hospital, Box Hill Hospital, Healesville & District Hospital, Maroondah Hospital,
Peter James Centre, Turning Point Alcohol & Drug Centre, Wantirna Health, Yarra Ranges Health and Yarra Valley Community Health
Members of Eastern Health: Angliss Hospital, Box Hill Hospital, Healesville & District Hospital, Maroondah Hospital,
Peter James Centre, Turning Point Alcohol & Drug Centre, Wantirna Health, Yarra Ranges Health and Yarra Valley Community Health
Decision Support Designs for Cerner Millennium
Stephanie Chau
ehCare Clinical Application Pharmacist
Eastern Health
Background
Eastern Health comprises of multiple sites and
provides to the public a wide variety of clinical
services:
Box Hill Hospital
Maroondah Hospital
Angliss Hospital
Peter James Centre
Wantirna Health
Healesville Hospital &Yarra Ranges Health
State-wide Footprint • Collaboration between:
– Department of Health, Victoria (Health Shared Services)
– Austin Health
– Eastern Health
– Peninsula Health
– Royal Eye & Ear Hospital
• Points for consideration:
– Standardised customisations
– Reduced cost
– Collaboration and increased ideas gateway
– Increase in turnaround time
– Difficulties in reaching mutual agreement
ehCare@eastern • Cerner Millennium application for clinical management
– PowerChart
– PharmNet Medication Manager
• Multum AU/NeHTA AMT identifiers
• ehCare@eastern: – Patient information
– Discharge prescribing
– Discharge Summaries
– Pathology & Radiology
– Fluid Balance Charts
– Inpatient prescribing
– Pharmacy review
Release 1
Release 2
Overview • Drug Interactions
• Allergies
• VTE risk
• Antimicrobials
• Medications
– PINCH
– warfarin
• Reports
• Future Functionality
Drug interaction settings • State decision – Major:Contraindicated
• Drug interaction data files are supplied by Multum AU
• Drug interactions classified into different levels of severity:
• Considerations: – Level of alert fatigue
– Meaningful interactions
Interaction Severity Example
Major:Contraindicated lithium-naproxen
Major:Major clopideogrel-rabeprazole
Major:Moderate metoprolol-oxycodone
Major:Minor captopril-lercanidipine
Allergy settings • Cerner system setting
• Functionality and terminology from Multum AU
• Levels:
– Drug or drug class allergy
– Associated drug classes
– Also includes non-drug data, eg. food, environment
Allergy Alert
Allergy settings • Cerner system setting – functionality and terminology from
Multum AU
• Levels:
– Drug or drug class allergy
– Associated drug classes
– Also includes non-drug data, eg. food, environment
• Considerations:
– Mandatory fields alignment
– Free text restrictions
– Unknown allergy status
Venous Thromboembolism risk • State decision
• VTE risk assessment form
• VTE alert
• Considerations: – Link to local policy
– Generalised default message
– Review of status
VTE Risk Alert
VTE Risk Form audit
Antimicrobial Alerts • Local decision – due to organisation specific restricted
antimicrobials
• Alert fires upon ordering conversation if drug is listed as
a restricted antimicrobial:
– Class B
– Class C
• Proceed to iGuidance approval system for EH
• Mandatory fields:
– Approval Number
• Reports
PINCH • P - potassium
• I - insulin
• N - narcotics
• C - chemotherapy
• H - heparins
• High dose insulin alert
• Caresets
• Special instructions & order
comments
• Additional charting elements
• Opioid patch removal tasks
• Selective orderable
virtualisation
PINCH • P - potassium
• I - insulin
• N - narcotics
• C - chemotherapy
• H - heparins
• High dose insulin alert
• Caresets & Power Plans
• Selective orderable
virtualisation
• Special instructions & order
comments
• Additional charting elements
• Opioid patch removal tasks
Order comments, patch removal
& additional charting elements
Warfarin build
Warfarin Alerts
Reports • Allergy KPI report
• VTE risk assessment report
• Freetext reports
• Laboratory values report
• Warfarin reports
Future Functionality
• Dose Range Checking
• Warfarin Summary Page
• Tall Man lettering
• Multiple anticoagulant alert
Thank you!