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CHANGES IN ALLERGY MANAGEMENT

CHANGES IN ALLERGY MANAGEMENT. by Steven Botwinski, R.Ph., Yvonne Kimura, Pharm.D. Bruce Matthias, R.Ph. The IN Group, Inc. February 18, 2009. Goals:. Outline the steps to convert from version 1a to version 2 allergy management Lessons learned from other facilities.

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CHANGES IN ALLERGY MANAGEMENT

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  1. CHANGES IN ALLERGY MANAGEMENT by Steven Botwinski, R.Ph., Yvonne Kimura, Pharm.D. Bruce Matthias, R.Ph. The IN Group, Inc. February 18, 2009

  2. Goals: • Outline the steps to convert from version 1a to version 2 allergy management • Lessons learned from other facilities

  3. Why Convert to Version 2? • FSV, no longer supports Version 1A allergy checking as of January 1, 2009 • Advanced clinical modules will require Version 2 MIS allergy management routines

  4. What Version Am I on Anyway? • Must be on Meditech Version 5.62 SR2 or higher • If your edit patient data screen has: • 1 page = Version 1A, need to convert to Version 2 • 2 pages = Version 1B - no need to convert • 4 pages = Version 2 - no need to convert

  5. General Steps and Timeline • Fix all NDC numbers - 1 or 2 months • Mapping and conversion in TEST - 2 days • Train end users - 1 month • Mapping in LIVE - 1 day • Conversion in LIVE - ??

  6. Open Meditech Task • Inform Meditech going through allergy conversion • Load any DTS’s that will be needed. (There my be quite a few) • Change toolbox parameters

  7. Fixing NDC Numbers • FSV updates allergy data by NDC number • The NDC number must be the correct drug • Validate NDC’s in TEST and LIVE • Correct drug • Valid NDC • Missing NDC

  8. Fixing NDC Numbers Consideration The NDC does not necessarily need to be a match to the exact product on the shelf BUT this is a good time to do that in preparation for BMV • Use purchasing history to match product on shelf • Consider fixing packaging strings and • acquisition cost data to prepare for cost based charging

  9. Fixing NDC Numbers Consideration The NDC does not necessarily need to be a match to the exact product on the shelf BUT this is a good time to do that in preparation for BMV • Use purchasing history to match product on shelf • 80/20 report(s) • Online catalog with purchase history

  10. Fixing NDC Numbers Consideration If taking the time to use purchase history to load NDC for product on shelf may want to prepare for Cost Based Charging • Fix packaging strings • Load acquisition cost data

  11. Formulary Service Vendor • First DataBank • Obtain new allergy data disc (DAM). This will be used to update the formulary after the conversion. • Load most recent quarterly update disc (DACN). Process all errors and file. • Load Version 2 allergies in TEST. Do NOT file yet.

  12. Formulary Service Vendor • Medispan / Micromedex • New disc already has allergy data • Perform quarterly update; process all errors • This suspense file to be used for allergy conversion

  13. Load FSV Allergy Data • Load FSV Allergy Data into a new suspense file BUT do NOT file yet. (“File allergens after load?” Set to No) • Allow system to auto-map. It is quite accurate.

  14. Mapping in TEST • Utilize the mapping routine to map current allergies on patients to the equivalent version 2 allergy. (Knowledge Based Article KB31161) • TEST may not have many existing allergies as compared to LIVE. If needed, add a few more.

  15. Load screen shot of mapping here

  16. Conversion in TEST • Pick patients with existing allergies to validate before and after conversion • Perform the conversion in TEST - usually quick due to small number of patients with allergies • Check patients after conversion to validate correct allergy conversion

  17. Train End Users and Change Custom Reports • In general reports will not need to be modified as the new allergy field will be utilized where the old allergy field exists. • EXCEPTION: Listing verified PLUS unverified allergies will require report modification(s) as only verified allergies will listed after the conversion in place of the old allergy field.

  18. Conversion in LIVE • Repeat steps in LIVE if TEST conversion is successful • Load Allergy Data into suspense file BUT do not FILE yet • Set up / restart allergy mappings • Mapping may take longer dependent upon number of patients in the database with allergies

  19. Conversion in LIVE • Conversion in LIVE - may take a long time if there are a lot of patients with allergies and concurrent activity processing active patients at the same time (weeks to months). Process occurs in the background.

  20. Summary • Conversion from Allergy Checking Version 1A to Version 2 is not difficult. • NDC is the key but accuracy will not be a problem as long as the NDC is for the correct drug (not necessarily the exact shelf item)

  21. Summary • Auto-mapping is accurate • Contact Meditech early to prevent delays • Remember load the suspense file first but do NOT file until the mappings are complete

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