Discontinuing Prescriptions

When prescribers discontinue prescription in EHRs, the medication discontinuation orders generally are not electronically communicated to the pharmacy which means that the clinic staff has to take the time to notify the pharmacies on discontinuations. The result is even though the discontinuations are removed from the EHR, these medications still remain on the pharmacy’s list and can be dispensed to patients.

CancelRx is a health IT tool that can be used to electronically communicate medication discontinuation orders between EHRs and pharmacies which allows for accurate pharmacy medication lists.

For over a decade, the National Council for Prescription Drug Programs, the creator of pharmacy health IT standards, has recommended that standards be implemented. A project has been initiated to evaluate the impact of implementing CancelRx at a large academic healthcare system.

This study to implement CancelRx, will take place at the University of Wisconsin Health- Madison (UW Health) https://www.uwhealth.org. UW Health serves over 600,000 patients in the Upper Midwest, has 80 outpatient clinics along with 15 community pharmacies. This project is being funded by the Agency for Health Research and Quality https://www.ahrq.gov, part of HHS, for $285,897 (grant number 821 H5025793) with a starting date of August 2018 to January 2020.

Healthlink EHR (EPIC) was implemented at UW Health in 2006 and the UW Health community pharmacies implemented a common pharmacy management system in 2008. Now a pre-post interrupted time series design will be used to determine if the medications electronically discontinued in the EHR are successfully removed from the pharmacy management software.

The study will:

  • Measure the impact of CancelRx on reducing medication discrepancies in the pharmacy management software
  • Describe the impact of CancelRx implementation on outpatient clinic and community pharmacy work systems

 

Observations and interviews will be conducted to understand the intervention’s impact on the work processes, workflow, and workload in the outpatient clinics and pharmacies. The success of the research depends on the successful implementation and dissemination of CancelRx at healthcare institutions.

 

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