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The project was completed in August Impact and Findings: The project found that arrangement of information is important to clinicians and may be an important form of cognitive support.
Recall of medication list items corresponded to experience level, with attending physicians recalling a median of 14 of 20 medications overall, residents a median of Student recall was greater with an organized medication list, but resident and attending physician recall was not affected by order, which contrasted with the teams' expectation that the organization of medication information would improve recall yet found data to support this for novices only.
However, it may be that processing of the list by the clinician is the more important factor. Recall by experts was high in either case, but subjectively they reported it was easier to recall the list items when they had to reorganize the lists themselves.
Medication reconciliation may occur as an isolated procedure designed to document compliance with regulations. However, medication management in long-term care was a richer, more robust, and more complex process, which is distributed, dynamic, collaborative, and continuous, involving multiple health professionals separately performing complementary tasks in different settings over time.
A prototype that demonstrated the feasibility of independent Web-based decision support services interacting in a service-oriented architecture over a network was developed.
This prototype will allow further exploration of the technical issues encountered, such as differences in drug terminologies used in existing systems, speed or access constraints of Web-based knowledge services, inclusion of extraneous data in medication information fields of local systems, and agreement on useful common classification schema for medication information.
Strategic Goal: Develop and disseminate health IT evidence and evidence-based tools to improve the quality and safety of medication management via the integration and utilization of medication management systems and technologies.
Our team would be pleased to give you a demonstration of our automation products and how they can help your pharmacy thrive in RxSafe believes in a partnership approach to pharmacy automation.
Our response? Order Supplies. RxSafe is the leader in robotic automation that improves patient safety and boosts profitability for retail and outpatient pharmacies.
Learn more at www. Ultimately, the project aims to show improvements in medication management by 1 providing the means to effectively share medication information, 2 making any corrections or improvements made by one team member to the regimen visible to all team members, and 3 providing clinicians using the system with access to evidence-based information at the time and place it is needed.
This project is a continuation of a successful collaboration between community-based nurses and physicians providing ambulatory services in an Oregon coastal community, a multidisciplinary team of university-based investigators with expertise in medicine, nursing, medical informatics, and computer science, and the Oregon Rural Practice-based Research Network, which provides the infrastructure, coordination, and support.
Clinical settings for the project are independent clinic practices in two coastal communities, local home health services, and transitions in care into and out of the single community hospital and its emergency room.
The patient focus is on community-dwelling persons with chronic conditions on multiple medications. The team configured these clients to interact through the versioning system SyncRx and explored the usefulness of this technology in prototype testing, to determine the requirements and challenges to its development and deployment Aim 3.
Refinement of the documentation for the parser function was completed. The prototype for the identifier module underwent trial-and-error testing.
The demonstration included services for parsing, identification using RxNorm , and classification using NDFRT of medication information, and a software harness to allow composition of these and other medication management services.
The project budget was significantly underspent. Funds will be used to underwrite expenses during the no-cost extension.
The project is focusing on analysis of field data and disseminating findings from field observation as well as software tools.
The team anticipates this will be a major activity moving forward. Preliminary Impact and Findings: The project team found that nurses, pharmacists, and physicians used different categorization schemes when thinking about medications.
Physicians form sophisticated initial mental models of the patient when performing a simple medication reconciliation task, and these models reinforce cognitive performance.
This work is embedded in other tasks relating to the total care of the patient. Finally, no publicly-available standard for classifying medications is in use, and this is a major barrier to effective multidisciplinary distributed decision support.
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The findings and conclusions in this document are those of the author s , who are responsible for its content, and do not necessarily represent the views of AHRQ.
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