Three 'must haves' as you specify a pharmacy interface for your EMR

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Brenda Kessler, RN, MBA
Brenda Kessler, RN, MBA

With the backbone of an Electronic Medical Record (EMR) system in place, many providers have interfaces on their radar in order to extend the value of their investment, create a richer picture of overall resident health, eliminate inefficient double data entry, and see deeper compliance benefits. Hands-down, a pharmacy interface is a top priority due to the far-reaching impact both of these have on reimbursement and risk management. 

But when it comes to pharmacy interfaces, the devil is in the detail of workflow.  Before you buy, make sure you weed out risky and inefficient double data entry. 

There are two types of automated pharmacy interface workflows to consider, depending on how you want to manage your operations.

  1. Pharmacy-centric, where the pharmacy enters the order and pushes it to your electronic medical record. 
  2. Facility-centric, where you enter the order directly into your medical record, and then push it to the pharmacy.

One is not better than the other; it really comes down to how you prefer running your business. The lion share of providers with interfaces use the facility-centric model in order to have maximum control over the order and to make sure the data in the medical record is squeaky clean. Providers say they prefer this workflow because they know the resident better than the pharmacy does.

As you shop for an interface, here are three must-haves to consider:

  1. No double entry. Some pharmacies may give you access to a portal to enter orders, which benefits the pharmacy more than it benefits you. This workflow is really not a pharmacy interface (unless of course you count the human as the interface). You'll have to enter the order twice: first in your electronic medical record, then in the pharmacy system, and pray they match.  Single point of order entry is essential for minimizing risk and cost. If someone is pitching a portal to you, ask to see the workflow mapped out.
  2. Two way. In the above scenario where you are double entering orders, you also have no flow of information back from the pharmacy into your electronic medical record.  So as a result, if the pharmacy adjusts the order, you have zero visibility. They will make the change and you'll have a manual step to make sure what they send you matches the order in your medical record. Make sure you can send and receive information in order for your medical records to be as accurate as possible. Remember that the goal is to streamline the workflow in processing orders. Make sure you ask the vendor specifically if the interface is bi-directional. This will eliminate those extra steps down the road.
  3. Seamless flow. When you enter your order in your medical record, it should flow automatically to the pharmacy system without touching it again. Likewise when you need a refill, you should be able to press an auto refill button and let the systems work behind the scenes with minimal human intervention for maximum efficiency.

As the industry increasingly rewards care coordination to reduce re-hospitalizations, tight control over order management is a top priority. For example if a resident is having a behavior issue during a med pass, the administering nurse has a total view at her fingertips. She can review meds to administer, note refusal, pull up behavior history, document behavior, document nurses notes, record vitals and more—all from one screen in seconds. And seconds later, her colleagues are automatically notified with accurate, near-real time information that interventions are needed.  A physician is notified, orders are updated, families are informed, and incidents are proactively managed. 

Imagine the same scenario in a paper-based system. During med pass, a resident is exhibiting behaviors.  Instead of a one stop process, this nurse will have to visit several places to gather information and complete her documentation as well as the necessary notifications. The increased time that it takes for this process in some cases could result in an adverse outcome for this resident.

It's all about good care coordination and decision support, and an automated, two-way, seamless pharmacy interface is a huge boost for quality of care – and quality of life – for residents.

Brenda Kessler, RN, MBA, is a clinical specialist at American HealthTech.

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