Literature DB >> 33835183

CancelRx: a health IT tool to reduce medication discrepancies in the outpatient setting.

Taylor L Watterson1, Jamie A Stone1, Roger Brown2,3, Ka Z Xiong4, Anthony Schiefelbein2, Edmond Ramly3,5, Peter Kleinschmidt3, Michael Semanik3, Lauren Craddock6, Samantha Pitts7, Taylor Woodroof7, Michelle A Chui1.   

Abstract

OBJECTIVE: Medication list discrepancies between outpatient clinics and pharmacies can lead to medication errors. Within the last decade, a new health information technology (IT), CancelRx, emerged to send a medication cancellation message from the clinic's electronic health record (EHR) to the outpatient pharmacy's software. The objective of this study was to measure the impact of CancelRx on reducing medication discrepancies between the EHR and pharmacy dispensing software.
MATERIALS AND METHODS: CancelRx was implemented in October 2017 at an academic health system. For 12 months prior, and 12 months after CancelRx implementation, data were collected on discontinued medications in the health system's EHR and whether those prescriptions were successfully discontinued in the pharmacy's dispensing software. An interrupted time series analysis was conducted to model the occurrence of prescriptions successfully discontinued over time.
RESULTS: There was an immediate (lag = 0), significant (P < 0.001), and sustained (post-implementation slope 0.02) increase in the proportion of successful medication discontinuations after CancelRx implementation (from 34% to 93%). CancelRx had variable impact based on whether the clinic was primary care (71.4% change prepost) or specialty care (53.9% change prepost). CancelRx reduced the time between when a medication was discontinued in the clinic EHR and pharmacy dispensing software.
CONCLUSION: CancelRx automated a manual process and illustrated the role for health IT in communicating medication discontinuations between clinics and pharmacies. Overall, CancelRx had a marked benefit on medication list discrepancies and illustrated how health IT can be used across different settings to improve patient care.
© The Author(s) 2021. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Entities:  

Keywords:  health information technology; implementation science; interrupted time series analysis; patient safety

Mesh:

Year:  2021        PMID: 33835183      PMCID: PMC8661442          DOI: 10.1093/jamia/ocab038

Source DB:  PubMed          Journal:  J Am Med Inform Assoc        ISSN: 1067-5027            Impact factor:   4.497


  25 in total

1.  Segmented regression analysis of interrupted time series studies in medication use research.

Authors:  A K Wagner; S B Soumerai; F Zhang; D Ross-Degnan
Journal:  J Clin Pharm Ther       Date:  2002-08       Impact factor: 2.512

2.  Prospective study of the incidence, nature and causes of dispensing errors in community pharmacies.

Authors:  Darren M Ashcroft; Paul Quinlan; Alison Blenkinsopp
Journal:  Pharmacoepidemiol Drug Saf       Date:  2005-05       Impact factor: 2.890

3.  Understanding CancelRx: Results of End-to-End Functional Testing, Proactive Risk Assessment, and Pilot Implementation.

Authors:  Samantha I Pitts; Noah Barasch; Andrew T Maslen; Bridgette A Thomas; Leonard P Dorissaint; Krista G Decker; Sadaf Kazi; Yushi Yang; Allen R Chen
Journal:  Appl Clin Inform       Date:  2019-05-22       Impact factor: 2.342

4.  Medication reconciliation in a community pharmacy setting.

Authors:  Caroline M Johnson; Todd R Marcy; Donald L Harrison; Ronald E Young; Eric L Stevens; Jill Shadid
Journal:  J Am Pharm Assoc (2003)       Date:  2010 Jul-Aug

5.  Adverse drug events in the outpatient setting: an 11-year national analysis.

Authors:  Florence T Bourgeois; Michael W Shannon; Clarissa Valim; Kenneth D Mandl
Journal:  Pharmacoepidemiol Drug Saf       Date:  2010-09       Impact factor: 2.890

6.  Electronic prescribing: improving the efficiency and accuracy of prescribing in the ambulatory care setting.

Authors:  Amber Porterfield; Kate Engelbert; Alberto Coustasse
Journal:  Perspect Health Inf Manag       Date:  2014-04-01

7.  Impact of a hospital-wide hand hygiene initiative on healthcare-associated infections: results of an interrupted time series.

Authors:  Kathryn B Kirkland; Karen A Homa; Rosalind A Lasky; Judy A Ptak; Eileen A Taylor; Mark E Splaine
Journal:  BMJ Qual Saf       Date:  2012-07-21       Impact factor: 7.035

8.  Pharmacy dispensing of electronically discontinued medications.

Authors:  Adrienne S Allen; Thomas D Sequist
Journal:  Ann Intern Med       Date:  2012-11-20       Impact factor: 25.391

Review 9.  Use of interrupted time series analysis in evaluating health care quality improvements.

Authors:  Robert B Penfold; Fang Zhang
Journal:  Acad Pediatr       Date:  2013 Nov-Dec       Impact factor: 3.107

10.  Transmitting and processing electronic prescriptions: experiences of physician practices and pharmacies.

Authors:  Joy M Grossman; Dori A Cross; Ellyn R Boukus; Genna R Cohen
Journal:  J Am Med Inform Assoc       Date:  2011-11-18       Impact factor: 4.497

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  2 in total

1.  Impact of CancelRx on discontinuation of controlled substance prescriptions: an interrupted time series analysis.

Authors:  Taylor L Watterson; Jamie A Stone; Aaron Gilson; Roger Brown; Ka Z Xiong; Anthony Schiefelbein; Edmond Ramly; Peter Kleinschmidt; Michael Semanik; Lauren Craddock; Samantha I Pitts; Taylor Woodroof; Michelle A Chui
Journal:  BMC Med Inform Decis Mak       Date:  2022-02-25       Impact factor: 2.796

2.  CancelRx implementation: Observed changes to medication discontinuation workflows over time.

Authors:  Taylor L Watterson; Sara E Hernandez; Jamie A Stone; Aaron M Gilson; Edmond Ramly; Michelle A Chui
Journal:  Explor Res Clin Soc Pharm       Date:  2022-01-25
  2 in total

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