Physician Order Entry

Physician Order Entry stands to greatly benefit from EMRs. No more scribble pads for prescriptions mean more legible orders can be filled accurately every time. Workflow facilitates pharmacy review and validation of order sets. Clinical warnings help providers avoid allergy conflicts to improve patient safety dramatically.  The EMRAM validation process is used to evaluate clinician use of ordering capabilities within the EMR.

Clinical Decision Support Systems (CDSS)

Clinical Decision Support Systems (CDSS) provide real time alerts warning providers (or clinicians taking orders from providers) of unfavorable outcomes. This functionality prevents orders that can cause allergic reaction or negative drug interactions. CDSS can also recommend evidence based protocol which reduces the risk of misdiagnoses and has vastly improved immunization rates since its inception. 

During an EMRAM validation, susceptibility for alert fatigue is evaluated and addressed to ensure that technology teams have carefully integrated clinician input to determine which alerts to activate in their system in order to avoid user complacency in addressing the electronic pop up messages. 

Medication Administration

Medication Administration advancements - including medication reconciliation and barcoding - are effective strategies for preventing adverse drug events through technology. This remains a top patient safety priority in hospitals and across the continuum of care. Both medical reconciliation and barcoding are required patient safety measures for organizations to mature and advance to the highest EMRAM stage. 

Medication reconciliation is the process of creating the most accurate list possible of all medications a patient is taking — including drug name, dosage, frequency, and route — and comparing that list against the physician’s admission, transfer, and/or discharge orders, with the goal of providing correct medications to the patient at all transition points within the hospital. Medication reconciliation becomes dramatically easier when the list follows the patient in their EMR.

Barcoding medications so that they may be validated in the pharmacy and at the point of administration is a patient safety “must-have”. Barcoding facilitates pharmacy tracking of compound medications as well as alerts in the absence of the five rights of medication administration.