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North State Rural Health Network (formerly Northern Sierra Rural Health Network)

North State Rural Health Network (formerly Northern Sierra Rural Health Network). E-Prescribing Pilot. Blue Shield of California Foundation. ePrescribing Pilot Goals. Advance the use of electronic prescribing in the NSRHN service area.

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North State Rural Health Network (formerly Northern Sierra Rural Health Network)

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  1. North State Rural Health Network(formerly Northern Sierra Rural Health Network) E-Prescribing Pilot Blue Shield of CaliforniaFoundation

  2. ePrescribing Pilot Goals • Advance the use of electronic prescribing in the NSRHN service area. • Share best practices statewide through CAL-ePrescribing Consortium.

  3. ePrescribing Pilot Objectives • Collect data for quality improvement and patient safety initiatives. • Coordinate a regular discussion forum to address local e-prescribing issues. • Develop a production testing model for providers and pharmacists.

  4. ePrescribing Pilot Objectives • Promote educational activities in response to expressed and identified needs. • Provide ongoing technical assistance for pilot clinics. • Build and sustain relationships with pilot clinic partners. Linda Kehoe, Network Coordinator Terry McClean, LVN - Fairchild Medical Clinic Kent Waldsmith, Project Manager - Lumetra

  5. Project Accomplishments • Facilitated the adoption of electronic prescribing at four clinic sites. • Developed training and technical support protocols for e-prescribing. • Recorded 13,771 electronic prescriptions since June 2008. • Hosted Pharmacist and Prescriber discussion forum kick off on November 9.

  6. NSRHN E-Prescribing Pilot Pharmacy Utilization

  7. Factors affecting reduced utilization: • Staff turn over (site champion leaves) • Turning off e-refills • EMR implementation • Factors affecting sustained utilization: • Administrative support • Training and technical support • Program Incentives, i.e. MIPPA

  8. Challenges • Functional limitations with prescribing tool. • Faxed refill requests. • Patient consent and opt out provision. Prescribing controlled medications.

  9. Site champion moved on Major construction project EMR implementation Deal Breakers • 1 Physician .25 FTE • No RN on staff • Patient safety concerns with med history in two places. • Billing system provider overcharging for interface.

  10. Lessons Learned • Set realistic expectations and expect delays. • Thoroughly document current workflow before redesigning new steps. • Road test eRx tool before selecting EMR product.

  11. Your Pharmacist is Your Friend

  12. Next Steps • Host educational workshops: • Workflow Redesign – Dec 3 • Coordinate discussion forums: • Improving e-refill rates • Achieving Meaningful Use • E-Prescribing controlled medications. • Reducing faxed refill requests. • Develop core group of pharmacists to participate in production testing with providers and EMR vendors. • Support CAL-eRx Consortium • www.calerx.org/

  13. What’s a One? • CME/CEU educational activity for physicians, RNs, and pharmacists. • Correct units, quantity, and SIGs for electronic prescription orders.

  14. Provider utilization and user satisfaction study. University of Arizona School of Pharmacy research team. Shasta Community Health Center 40 providers. 24,000 Electronic Prescriptions/Month CA HealthCare Foundation project - June 2010. eRx Evaluation Project

  15. NSRHN E-Prescribing Pilot Pharmacy Utilization

  16. erxnow.allscripts.com Free provider accounts. Suitable for smaller practices.

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