Wow - I always "assumed" that unverified orders did not appear on dispensing
machine profiles until they were verified. Now I want to check those profiles
as well. We never had unverified orders being entered until recently and we
have some night techs entering unverified orders. Now I am really curious to see
what is happening. I don't think either the old way or the "new way" is quite
right.
Currently, if a patient is discharged, all his verified orders are DC'd -
correct? And you are saying that the way it used to be is that if you had an
unverified order entered and a patient was discharged before it was verified,
the order was then canceled. In that case, if an order was pulled from a
machine on override without a verified order, you would have the override debit
to note that the med was pulled, but you would still have to go back and
"find" the matching order in the chart to verify that the med was pulled
against a real order. With your update, UNVERIFIED orders are AUTO-verified
when
the patient is discharged, and then , I am guessing, they should be DC'd right
after and they would have no debit or dispense associated to them. If the
nurse pulled the med before the order was verified, there would still be an
override order - correct. With the updated version, there would be an unverified
order which was autoverified and DC'd, so I guess that would help with
"matching" the over-ride against an order. But the order would technically
still be
unverified by a pharmacist and the written copy would still have to be pulled
from the chart.
This is what I think "should" happen - although I know it
probably won't happen this way.
If an order is entered as Unveriified and the patient is discharged before the
order is verified, the Unverified order should be DC'dU (DC'd as unverfied)
That way, if an over-ride is pulled against a written order, you can match the
over-ride pull against the unverified order and then see if the pharmacist
was just way behind in verification or whatever on that day.
If the unverified order is CANCELED - it disappears and there is no record of
even an attempt to enter the order being done. On the other hand, if the
Unverified order is auto-verified by the system and then DC'd, it gives an
initial picture of the order having been verified by "someone", thus if the
unverified order was entered incorrectly and then auto-verified, but the med
was pulled on override just prior to the discharge, it could appear as though
the wrong dose/med
was pulled on over-ride ( or the other way around).
It just doesn't seem quite right the way it is currently programmed. thanks
cindy
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<[EMAIL PROTECTED]>
Sent by: [email protected]
To
"'Allan
Townsend'" <[EMAIL PROTECTED]>, <[email protected]>
04/30/2007 01:48 PM
cc
[EMAIL
PROTECTED]
Subject
Please respond to RE:
[SPAM] [MEDITECH-L] C/S 5.5.2 PHA Unverified Orders
[EMAIL PROTECTED]
Hey David/Allen-
My knee jerk response is most likely the same as many others - why are UNV
orders sitting in the queue that long? But besides that, I think the catch
for me is...have the meds been dispensed and/or possibly administered? Are
these UNV orders entered by Pharm Techs or do you use POM? For patient
safety, I believe most site DO NOT have UNV orders cross to the eMAR or a
dispensing cabinet - so that should leave the possible "floor stock" or an
override from the cabinet as a choice for nursing to get the med in the
first place.
I am certainly not defending MT, but my understanding was the use of
auto-verify has to do with billing...a CAN order goes no where. I don't
like it either, but I think as you roll with the update and the changed
functionality (that goes for any app with any update/new release) we are
forced to re-assess our current workflow and it lends toward the opportunity
for some process re-design.
Best of luck - Kevin.
Kevin McConnell, PharmD.
Clinical Consultant
(713)480-6810
[EMAIL PROTECTED]
www.RPhInformatics.com
-----Original Message-----
From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf Of
Allan Townsend
Sent: Thursday, April 26, 2007 1:37 PM
To: [email protected]
Cc: [EMAIL PROTECTED]
Subject: [SPAM] [MEDITECH-L] C/S 5.5.2 PHA Unverified Orders
Hello; a posting on behalf of our PHA specialist
We recently took a service release and jumped from 5.3.6 to 5.5.2. After
the update we discovered that unverified orders were no longer being
treated the same way in the Pharmacy module. Previously, if an unverified
ordered was on a patient profile and the patient was discharged before the
order was verified, the order would be cancelled. With the new release,
the order is now auto-verified by the system. We perceive this as quite
dangerous. Have any other sites had experience in dealing with this issue.
David Evans
HITS-NS
Pharmacy Application Specialist
[EMAIL PROTECTED]
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