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

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348 S.H. Mitchell et al. context of medication delivery include: receipt of drugs from pharmacy, retrieval of locally stored drug doses intended for patients, checking, and matching of drug doses to patients according to schedule, checking for contraindications, administering the medication properly, recording administered doses, and monitoring the patient. Nursing information needs include: general disease and drug-specific knowledge and patient-specific data regarding medications and other care (Chapter 28). 27.3 Pharmacy Information Systems (PharmIS) Pharmacy information systems (PharmIS) 2–4 are computerized systems that support the management and dispensing of drugs, including inventory, reporting, and cost tracking. In many cases, they are comprised of a central database (data on drugs in the formulary), interfaces (views) that provide access to information (such as inventory reports) and clinical decision support (CDS). PharmIS may act as a standalone system (accessible to pharmacy staff only) and/or may be connected to computerized provider order entry (CPOE), electronic medical records (EMR) and/ or electronic medication administration records (eMARs) as part of an integrated health information technology (HIT) system. 27.3.1 Central Database The central database manages current and detailed information about drugs used within an institution. Functions of the central database should include the ability to: Store and make available pharmacologic knowledge about formulary drugs, including drug interactions and patient information sheets in a form accessible to users (according to language and literacy levels) Import and update drug information from commercially available data dictionaries Link patient-specific drug information, including current diagnoses, medications, allergies, and contraindications and nonformulary drugs Track cumulative dosages of identified drugs (such as chemotherapy) Newer functionalities include abilities to: Interoperate with other data systems, such as ePrescribing networks and pharmacy benefits management systems Provide paperless package inserts Pediatric specific functionality should include: Weight and body-surface area based dosing information and calculation support Age-based pharmacologic data
27 Dispensing: Pharmacy Information Systems 349 27.3.2 Interfaces Interfaces connect the central database to other information systems and to users (including patients). Selection of pharmacy information systems may be based in part on the interfaces that are provided or that are possible (that may be negotiated with a vendor). Interfaces may provide: Physical access to pharmacy information for users � Computer workstations (online access to drug libraries, handbooks) � Telephone (direct consultation with an on-site pharmacist in the case of standalone databases) � Mobile devices (handheld/wireless) Print media (handbooks, brochures) Functional tools to help users locate information � Search engines � Calculators for doses, body surface area � Reference charts to normal values Integration with clinical information and workflows � Electronic medical records � Computerized provider order entry � Electronic medication administration records Interoperability with external information systems � Financial information systems � Benefits information systems � Commercially available data dictionaries Specific configurations for interfaces between a PharmIS and CPOE include: complete integration of the two systems, a bidirectional interface, a unidirectional interface or not using an interface. Each has advantages and disadvantages and these should be considered carefully when deciding on a system. 2 27.3.3 Clinical Decision Support Clinical decision support (CDS) provides “clinicians, patients or individuals with knowledge and person-specific or population information, intelligently filtered or presented at appropriate times, to foster better health processes, better individual patient care.” 5 Functionalities of PharmIS CDS include: Checking doses based on allowed dose ranges Detecting known allergy and drug interactions Identifying and flagging duplicate orders/therapies Providing patient and drug-specific warnings Intercepting drug incompatibilities (intravenous admixtures)
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Health Informatics (formerly Comput
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Editors Christoph U. Lehmann George
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vi Series Preface changes to both t
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viii Foreword This text will prove
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x Preface financial investment and
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How to Use This book This book is t
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xvi Contents 9 Pediatric Care, Safe
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xviii Contents Part VII A Vision an
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xx Contributors Donna M. D’Alessa
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xxii Contributors Christoph U. Lehm
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xxiv Contributors Mark M. Simonian,
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4 G.R. Kim pharmacy, medical educat
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6 K.B. Johnson and G.R. Kim Deaths
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8 K.B. Johnson and G.R. Kim 2.4.1 I
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10 K.B. Johnson and G.R. Kim 2.4.3
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12 K.B. Johnson and G.R. Kim Educat
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14 K.B. Johnson and G.R. Kim 2.6 Co
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Chapter 3 Core Pediatric Data Kevin
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3 Core Pediatric Data 21 3.3 Pediat
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3 Core Pediatric Data 23 3.6 Pediat
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Chapter 4 Neonatal Care and Data De
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4 Neonatal Care and Data 27 Essenti
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4 Neonatal Care and Data 29 4.3 The
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4 Neonatal Care and Data 31 some ma
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4 Neonatal Care and Data 33 Measure
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4 Neonatal Care and Data 35 4.5.2.4
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4 Neonatal Care and Data 37 4.6.3 I
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4 Neonatal Care and Data 39 4.7.2.2
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4 Neonatal Care and Data 41 Availab
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44 D.M.N. Paperny Tasks related to
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46 D.M.N. Paperny Behavioral risk d
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48 D.M.N. Paperny for outside ancil
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50 D.M.N. Paperny Video reinforceme
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52 D.M.N. Paperny 3. Litzelman DK,
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Chapter 6 Children with Development
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6 Children with Developmental Disor
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Chapter 7 Pediatric Emergency and P
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7 Pediatric Emergency and Pediatric
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84 W.H. Drummond et al. A recovery
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86 W.H. Drummond et al. 8.2.2 Forma
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88 W.H. Drummond et al. 8.2.2.1 Sys
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90 W.H. Drummond et al. The multidi
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92 W.H. Drummond et al. noise overl
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94 W.H. Drummond et al. needs requi
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96 W.H. Drummond et al. Children’
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98 W.H. Drummond et al. After the P
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100 W.H. Drummond et al. Table 8.2
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104 W.H. Drummond et al. when to su
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106 W.H. Drummond et al. It is crit
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108 W.H. Drummond et al. traditiona
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110 W.H. Drummond et al. and human
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112 W.H. Drummond et al. blood prod
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116 W.H. Drummond et al. 35. Collin
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Chapter 9 Pediatric Care, Safety, a
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9 Pediatric Care, Safety, and Stand
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134 D.M. D’Alessandro The EBM pro
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136 D.M. D’Alessandro 10.4 Pragma
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138 D.M. D’Alessandro 4. Case ser
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140 D.M. D’Alessandro Ontario, BC
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142 D.M. D’Alessandro Table 10.1
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144 D.M. D’Alessandro Children ar
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146 D.M. D’Alessandro 17. Ely JW,
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Chapter 11 Clinical Practice Guidel
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11 Clinical Practice Guidelines: Su
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162 M.J. Feldman in patients withou
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164 M.J. Feldman The art of medicin
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166 M.J. Feldman important design g
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168 M.J. Feldman Incorrect or missi
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170 M.J. Feldman Fig. 12.4 GIDEON D
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172 M.J. Feldman system or etiology
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174 M.J. Feldman ED-12: “Practica
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176 M.J. Feldman Fig. 12.7 DXplain:
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178 M.J. Feldman For GIDEON: Rabies
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180 M.J. Feldman KB on infectious d
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182 M.J. Feldman 4. Johnson KB, Fel
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Chapter 13 Managing Pediatric Knowl
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13 Managing Pediatric Knowledge Res
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Chapter 14 Supporting Continuing Pe
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14 Supporting Continuing Pediatric
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14 Supporting Continuing Pediatric
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Chapter 15 Pediatric Care Coordinat
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15 Pediatric Care Coordination: The
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Chapter 16 Prioritizing Pediatric I
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16 Prioritizing Pediatric Investmen
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Chapter 17 Aligning Pediatric Ambul
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17 Aligning Pediatric Ambulatory Ne
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258 G.R. Kim and C.U. Lehmann Elect
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260 G.R. Kim and C.U. Lehmann 18.2.
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262 G.R. Kim and C.U. Lehmann There
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264 G.R. Kim and C.U. Lehmann 13. C
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266 K.B. Johnson and C.G.M. Weigle
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280 C. Sable et al. computer for la
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282 C. Sable et al. Table 20.3 Tele
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284 C. Sable et al. without increas
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286 C. Sable et al. Fig. 20.1b Wash
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288 C. Sable et al. prior to case d
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290 C. Sable et al. presence of con
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292 C. Sable et al. 17. Sable C, Ro
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402 J.H. Schneider on governance, u
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404 J.H. Schneider 31.6.1 Data Rele
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406 J.H. Schneider Understanding op
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408 J.H. Schneider of this componen
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410 J.H. Schneider Table 31.1 (cont
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412 J.H. Schneider References 1. Am
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Chapter 32 Developing Pediatric Dat
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32 Developing Pediatric Data Standa
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430 G.R. Kim and S.T. Rosenbloom Co
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432 G.R. Kim and S.T. Rosenbloom No
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434 G.R. Kim and S.T. Rosenbloom pr
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436 G.R. Kim and S.T. Rosenbloom ab
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Chapter 34 Pediatric Research and I
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34 Pediatric Research and Informati
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Chapter 35 The Moving Picture of Pe
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35 The Moving Picture of Pediatric
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470 G.R. Kim and K.B. Johnson Cente
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472 G.R. Kim and K.B. Johnson 36.4
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Index A 2006 AAP recommendations on
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Index 477 psychological data, 45 se
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Index 479 High frequency flow inter
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Index 481 O Online Mendelian Inheri
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Index 483 Standards development org
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