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Scott Hoch

on 23 April 2014

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Transcript of mCDS

1. Ease of use
2. hover tips
3. hyperlinks for drill-down specific information.
4. customizable drug content in Multum Custom tool
5. Override reason filtering
6. Cancel/DC from the window
7. Sticky notes

Can also display Discern rule output related to interaction pairs, or display output not related to the multum alert.
Why change?
mCDS - Medication Clinical Decision Support
This filter determines which types of allergy reaction classes should be filtered out of drug-allergy checking. "Side effect" and "Intolerance" are Cerner recommended values to filter.
Determines whether duplicate therapy checking should be applied across both inpatient and outpatient drugs, or to check exclusively inpatient or outpatient drugs. Change from 1 to 0, the Cerner recommended value to use filtering capabilities across venues of care. Applies to all types, not just duplication

...if you decide to filter clinical checking when orders are transferred from outpatient (history) to inpatient both HXIP and IP should = Yes. Same case holds true if the orders are being transferred from inpatient to prescriptions (outpatient). Both IPRX and RX = Yes.

If using Duplicate Therapy Checking in PowerOrders, the recommendation is to set all venue filtering to Yes.

If not using Duplicate Therapy Checking in PowerOrders
, the recommendation is to set the Home to Inpatient and the Inpatient Filtering to Yes and the Inpatient to Prescription and Prescription filtering to No.

1. MUL_DS_STYLE change from 0 to 1
2. MUL_MPAGE_VIEW change from 0 to 1
1 = invoked when adding an orderable the scratchpad or selecting the product to add
2 = invoked later, when signing orders or clicking OK

Technical implementation
4 settings available in Bedrock to reduce nuisance alerts
1. Display Discern Rule Output based on interaction pairs
*SYNCHEVENT to evoke
2. Display Discern Rule Output not related to Multum alerts
Suppression of Alerts across Venues of Care
Coooool add-ins requiring further build
Output not related to the interaction displays in the Discern Alert section
4 types of filtering
from uCern
Current decision support window
new Medication Clinical Decision Support (mCDS) window
Other values: Adverse effect, allergic reaction, allergy, idiosyncratic, Other, secondary effect, toxicity, unkown and sensitivity.
1. Home Med to Inpatient (HXIP)
2. Inpatient (IP)
3. Inpatient to Prescription (IPRX)
4. Prescription (RX)

HXIP/IP/IPRX/RX are all set to Yes
- All clinical checking would be filtered when the medications orders are moved across venues of care

HXIP and IP = Yes and IPRX and RX = No
- Clinical checking would be filtered when medication orders are moved from history (outpatient) to inpatient but would NOT be filtered when medication orders are moved from inpatient to prescriptions (outpatient)

HXIP and IP = No and IPRX and RX = Yes
- Clinical checking would NOT be filtered when medication orders are moved from history (outpatient) to inpatient but would be filtered when medication orders are moved from inpatient to prescriptions (outpatient)

HXIP/IP/IPRX/RX are all set to No
- All clinical checking will NOT be filtered.
The alert message is displayed beneath the interaction information in the row with the interaction pair.
Cooool add-ins to turn ON or OFF
1. Sticky Notes
2. Cancel/DC
The DC happens as soon as the user clicks continue. The order remains discontinued even if the order action that created the alert is not submitted. It will not display as DC'd until the profile is manually refreshed or patient is re-loaded.
Other misc:
Clicking links will open additional reference data about the medication, previous alert history, and the interaction information.

Reference Text and Citations
The reference text, patient education leaflets and citations are available via links on drug names. Citations are provided to meet Meaningful Use requirements.

users may click on allergies to launch the standard allergy window to review and modify if necessary

the order just placed may be removed by the "Remove New Order" which flexes based on the order action. e.g. "Stop Verify Action"

DC reasons can be required or optional

override reasons can be customized per interaction type
override reasons can be applied to multiple lines or one reason may be selected for all.

Order detail filtering and provider group filtering.
Full transcript