Pediatric Informatics: Computer Applications in Child Health (Health ...

19 Ambulatory Computerized Provider Order Entry 267
Fig. 19.1 Typical eRx interface: Vanderbilt RxStar System: This eRx application guides prescribers
in: (a) constructing new prescriptions and (b) refilling/renewing prescriptions. eRx systems
may feature: access to medications and tests, active orders, medication administration records,
automated reports, and decision support (checks, alerts, and reminders for dosing errors, potential
drug allergies, and interactions)
collect, preserve/store, and send) a biological or clinical sample for analysis, the
need for a trained medical professional to perform an ordered test/procedure (blood
drawing), documentation of clinical findings that justify the test/procedure (such
as a referral), tracking and communication of the performance/cancellation of the
procedure/test and the results of the procedure/test. Completion of all the necessary
steps of this process is termed fulfillment (of the order).
It is important to note that fulfillment is a component of both eRx and eDx,
but that because of the physical separation of most pharmacies from clinic sites,
the fulfillment component (whether the prescription has been picked up) has traditionally
been retained in the pharmacy information system. This distinction is
also under scrutiny—many new systems exploit data feeds from retail pharmacies
(e.g., SureScripts ) or insurers (e.g., RxHub ) to inform payors and clinicians
about prescription fulfillment.
19.2.4 ACPOE Versus Inpatient CPOE
Ambulatory prescribing is largely similar to inpatient prescribing (Chapter 26)
in most ways. Differences include: workflow role-based tasks (differential roles
of nurses and pharmacists in dispensing and administration), the use of dosing