Inpatient Physician Ordering System

Greetings all! My name is David Vu, a pharmacist and engineer for a pharmacy technology company. I have been working with @robert.down and other members of the OpenEMR team to develop the inpatient module. One of things we have discussed was CPOE for the inpatient module.

There are several components of this, but one of them we thought about was the integration of Medication Reconciliation in regard to a patient’s inpatient stay. When a patient enters the facility, medication reconciliation is done where all the patient’s medications are up to date. This is pertinent because their medications must be continued, held, discontinued, etc. Also, many major inpatient clinical decisions are made with respect to the current medications that they are/were taking.

However, current medication reconciliation in OpenEMR could be improved upon. So I’m looking into a feature: Improving Robustness of Medications in “Medications in Patient Profile” and “Prescriptions”.

To start, For “Medications” - Fields that could be included would be Strength, Formulations (extended release, immediate release.), Form Factors (tablets, capsules, etc.), Route, Frequency, Last dose taken.

Please let me know your thought on creating these additional features!

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The improvement in the medication list would lead into the Inpatient Ordering. Then we could consider integration of Medication Reconciliation into CPOE.

At that time, we can think about other items:

-Workflow points to consider:

  • Medrec from outpatient-to-inpatient
  • Medrec from inpatient-to-discharge
  • Medrec within inpatient, through transitions of care, i.e. ICU to Med Surg

-Consider how will each medication order be flagged that it has been reconciled, by who, date/time etc.

  • Recall that every point of care-transition may need a medrec depending on the hospital facilities
  • Do we want a medication from the outpatient side to be seamlessly. Or do we want it to suspend the outpatient order and create a new order copied from the outpatient one but now labeled as inpatient with a reference to the copy source?

-Mapping of fields from outpatient/historical/SureScript orders to appropriate inpatient medication orders

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