Development and implementation of autoverification best practices

To describe a pharmacist-led process to reevaluate alignment of autoverification practices with medication safety principles and regulatory requirements.

Autoverification occurs when a medication order bypasses pharmacist verification and is automatically verified in the electronic health record (EHR). Because of limited guidance on safe implementation of autoverification and debated interpretation of current regulatory recommendations, an opportunity was identified to review existing literature and reevaluate autoverification principles. This single-center quality improvement study conducted at a large academic medical center included elements such as review of the literature, EHR configurations, regulatory standards, national organizations' guidance, and internal autoverification data. This project was separated into phases: (1) characterization of the institution's preimplementation autoverification practices; (2) crosswalk of the institution's autoverification practices with recommendations from ASHP and The Joint Commission; and (3) development and implementation of an updated process and policy. Identification of medication safety gaps led to redesign of the autoverification algorithm and implementation of a newly developed autoverification policy and maintenance process in alignment with regulatory requirements. Algorithm redesign resulted in simplification of the overarching rules, decreasing their number from 16 to 4, with each rule representing a medication category for which the institution decided to allow autoverification. Postimplementation data showed no significant change in the number of orders autoverified for most care areas, although there was an increase in the percentage of autoverified orders derived from order sets.

The pharmacy department successfully implemented a redesign of the institution's autoverification policy and EHR configurations to align with current regulatory standards and ensure a process to appropriately review new autoverification proposals.