Pharmacy information systems are, simply put, the computer systems that the pharmacy uses to manage all the information required to care for patients.1 Although such systems may appear straightforward at first glance (see Figure 7-1), they accommodate some of the most important clinical, documentation, and communication functions in the pharmacy, such as
- Clinical screening for drug interactions
- Prescription order entry
- Prescription and inventory management
- Patient profiles
- Reports of medication use
- Interactions with other systems related to payment, regulatory compliance, and so on
These systems have led to many improvements in data management and patient safety, including faster processing of orders and prescriptions, reduced medication errors, and improved adherence to medication-use policies or drug formularies (see Chapter 13) within an institution.2,3 Table 7-1 includes some terminology related to pharmacy information systems and their most common functions, as described below.
Clinical Screening
When information is entered into the patient profile, the pharmacy information system stores the records and applies the information to future prescriptions filled in the pharmacy. The pharmacy computer screens a patient’s medication list, drug allergy information, current or former smoking or alcohol history, pregnancy status, age, weight, and much more information every time a new prescription or medication order is entered. Some pharmacy information systems also allow you to document previous medication adverse events or patient risk factors. When entering information into the computer, be complete and accurate to ensure that all data are correct and properly updated.
DEFINITION | |
Computerized Physician Order Entry (CPOE) | Physicians or other providers enter medication orders directly into the computer system on the patient-care unit or floor instead of transmitting a written or verbal order to the pharmacy for order entry. |
Electronic medical record (EMR) | An electronic or digital version of a patient’s chart that allows providers to track patient data, identify ongoing patient needs, monitor specific laboratory or other parameters over time, and handle many other components of a patient’s care within a single pharmacy or institution. |
Electronic health record (EHR) | Similar to an EMR, but often provides additional information about the patient’s history outside of a single institution. In some cases, patients may have access to their EHR information when they see providers in different institutions or practices. |
Clinical information system | A computerized pharmacy information system that also provides information on the clinical care of patients, such as electronic medication administration records, laboratory and other patient data, and diagnoses. |
Clinical decision support (CDS) | Electronic tools to help pharmacists, physicians, and other providers or individuals involved in health care make informed decisions about treatment or other options. CDS systems may include drug-interaction alerts with alternative treatments, predetermined order sets for high-risk medications, links to clinical guidelines, and many other resources. |
Electronic prescribing (e-prescribing, e-Rx) | Computer-based generation and transmission of a prescription directly from the prescriber, usually to an outpatient or mail-order pharmacy. In contrast to CPOE, which generally occurs within a single closed system, e-prescribing transmits a prescription electronically between separate systems (e.g., from the provider’s office to the pharmacy), taking the place of paper, faxes, or telephone orders. E-prescribing can reduce medication errors because it removes subjective factors such as illegible handwriting, but it may also introduce new types of errors, such as a prescriber selecting the wrong medication from a drop-down menu. |
Prescription Records and Management
At minimum, a patient’s prescription record will include basic information about their current and past prescriptions (Table 7-2). Although specific details depend on which computer system your pharmacy uses, nearly all pharmacy systems use prescription records in the dispensing process. Many also interface prescription records with inventory to verify if a specific product is in stock or even track which stage of dispensing any given prescription or medication order is currently in. As a technician, understanding the prescription records and management components of your pharmacy’s information system will be a key to your success in the pharmacy.
Inventory Management
With the number of drugs and pharmaceutical products on the market, it would be nearly impossible to keep track of pharmacy inventory (see Chapter 13) without computerized systems. Pharmacy computer systems are often used to maintain accurate counts of current inventory, display an alert when products go below a preset quantity, identify appropriate suppliers for product replacement, or automatically reorder products.
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