HIT-Based Regional Medication Management Pharmacy System

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Project Details -
Completed

The purpose of this project was to utilize health information technology (health IT) to provide geographically remote Critical Access Hospitals (CAHs) with around-the-clock access to pharmacist expertise when each CAH's local pharmacist is unavailable. Eight CAHs in rural northern Minnesota communities and a tertiary-care hospital in Duluth, MN with around-the clock pharmacy operations participated in the project. The Internet linked the MEDITECH patient information management system at each CAH to the urban hospital pharmacy. When the local pharmacist was unavailable, the CAHs faxed new medication orders to the urban hospital for pharmacist review. The urban hospital pharmacist downloaded the CAH patient's EMR via the Internet, reviewing the new medication orders against the patient's record for appropriateness of indication, formulary availability, dose, frequency, duplicative therapy, etc. The urban hospital pharmacist would verify the order, releasing the medication from an automated dispensing cabinet located at the rural CAH. Implementation challenges were identified and addressed. Clinical Messages transmitted from the urban pharmacists to CAH nursing staff and prescribers regarding medication orders positively impacted patient care by avoiding medication misadventures. Patients in geographically isolated rural CAHs received safer and more effective medication therapy than if there were no pharmacist involvement and the system was well accepted by CAH nursing and pharmacy staff.