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Ambulatory Medication Change Workflows' Effect on Communication to Pharmacies.
Samantha I Pitts1, Bridgette Thomas2, Yushi Yang3
1Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
Applied Clinical Informatics
|May 21, 2025
Summary
CancelRx medication discontinuation notices are not consistently sent to external pharmacies due to varied electronic health record (EHR) workflows. Optimizing CancelRx configuration and provider workflows is crucial for accurate medication change communication.
Area of Science:
- Health Informatics
- Pharmacy Practice
- Clinical Informatics
Background:
- CancelRx facilitates medication discontinuation communication between electronic health records (EHRs) and pharmacies.
- Effective CancelRx implementation can reduce medication discrepancies and prevent dispensing after discontinuation.
- Provider workflows and system configuration influence medication change notifications to pharmacies.
Purpose of the Study:
- To assess how CancelRx configuration and EHR tools impact medication change notifications to internal and external pharmacies.
- To evaluate the effectiveness of different provider workflows in communicating medication discontinuations and new prescriptions.
Main Methods:
- Functionality analysis of prescriber workflows for medication changes (e.g., 'change', 'reorder', 'adjust sig', 'discontinue', 'taking differently').
- Examination of prescription cancellation, new prescription generation, and patient instructions within an EHR test environment.
Main Results:
- The 'change' function with default settings consistently communicated discontinuation to both internal and external pharmacies.
- 'Reorder' and 'adjust sig' functions showed inconsistent cancellation outcomes between internal and external pharmacies.
- 'Adjust sig' also yielded different prescribing outcomes, and 'taking differently' failed to communicate discontinuation or new prescriptions.
Conclusions:
- Certain EHR workflows for dose adjustments do not reliably notify external pharmacies, leading to prescription discrepancies.
- Health systems must evaluate local EHR workflows and CancelRx configuration for effective medication change communication.
- Multidisciplinary collaboration is essential to improve communication strategies for medication dose changes.
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