A Pharmacy Blueprint for Electronic Medical Record Implementation Success

Abstract

Objective: Implementation of an integrated, electronic medical record (EMR) has been promoted as a means of improving patient safety and quality. While there are a few reports of such processes that incorporate computerized prescriber order entry, pharmacy verification, an electronic medication administration record (eMAR), point-of-care barcode scanning, and clinical decision support, there are no published reports on how a pharmacy department can best participate in implementing such a process across a multihospital health care system. Method: This article relates the experience of the design, build, deployment, and maintenance of an integrated EMR solution from the pharmacy perspective. It describes a 9-month planning and build phase and the subsequent rollout at 8 hospitals over the following 13 months. Results: Key components to success are identified, as well as a set of guiding principles that proved invaluable in decision making and dispute resolution. Labor/personnel requirements for the various stages of the process are discussed, as are issues involving medication workflow analysis, drug database considerations, the development of clinical order sets, and incorporation of barcode scanning of medications. Recommended implementation and maintenance strategies are presented, and the impact of EMR implementation on the pharmacy practice model and revenue analysis are examined. Conclusion: Adherence to the principles and practices outlined in this article can assist pharmacy administrators and clinicians during all medication-related phases of the development, implementation, and maintenance of an EMR solution. Furthermore, review and incorporation of some or all of practices presented may help ease the process and ensure its success.

What to expect from electronic patient record system implementation: lessons learned from published evidence

“…Investment of time during procurement for system selection and technology hardware requirements, along with optimising workflows are all associated with successful implementations,44 with workflow optimisation in particular being a major ongoing component 32 , 45. Whilst initial emphasis is ensuring safe EPR functionality, this should evolve towards user customisation and secondary use of data to improve outcomes, such as patient safety 46.…”

Clinical Outcomes of Student Pharmacist–Driven Medication Histories at an Academic Medical Center

“…In order to provide process improvements within the EMR, it is essential for the department of pharmacy to be involved with Information Technology Services and other health-care professionals as decisions are made and upgrades are implemented within the EMR. 23,24 A systematic review of medication reconciliation interventions did not demonstrate a decrease in rehospitalization but hypothesized that an impact would be seen if these activities were bundled with other interventions at the transitions of care. 25 The ASHP-American Pharmacists Association Medication Management in Care Transitions Best Practices supports this hypothesis, and as a result, 8 organizations were awarded the ASHP Best Practice Award secondary to demonstrating a decrease in hospital readmissions.…”

“…In order to provide process improvements within the EMR, it is essential for the department of pharmacy to be involved with Information Technology Services and other health-care professionals as decisions are made and upgrades are implemented within the EMR. 23,24…”