Development and implementation of autoverification best practices.

Area of Science:

• Pharmacy Practice
• Health Informatics
• Medication Safety

Background:

• Autoverification (AV) allows medication orders to bypass pharmacist review in electronic health records (EHRs).
• Limited guidance and debated regulations necessitate reevaluation of AV safety principles.
• A quality improvement initiative addressed these challenges at a major academic medical center.

Purpose of the Study:

• To describe a pharmacist-led process for reevaluating autoverification practices.
• To ensure alignment with medication safety principles and regulatory requirements.
• To redesign the autoverification algorithm and policy for improved safety and compliance.

Main Methods:

• Literature review and analysis of EHR configurations.
• Crosswalk of existing AV practices with guidelines from ASHP and The Joint Commission.
• Phased implementation including characterization, gap analysis, and policy redesign.

Main Results:

• Identification of medication safety gaps led to algorithm redesign, simplifying rules from 16 to 4.
• Implementation of an updated AV policy and maintenance process.
• Postimplementation showed no significant change in AV order volume, but increased use of AV for order sets.

Conclusions:

• The pharmacy department successfully redesigned the autoverification policy and EHR configurations.
• The updated process aligns with current regulatory standards.
• A system is now in place for appropriate review of new AV proposals.