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Our response? Recall of medication list items corresponded to experience level, with attending physicians recalling a median of 14 of 20 medications overall, residents a median of Student recall was greater with an organized medication list, but resident and attending physician recall was not affected by order, which contrasted with the teams' expectation that the organization of medication information would improve recall yet found data to support this for novices only.
However, it may be that processing of the list by the clinician is the more important factor. Recall by experts was high in either case, but subjectively they reported it was easier to recall the list items when they had to reorganize the lists themselves.
Medication reconciliation may occur as an isolated procedure designed to document compliance with regulations. However, medication management in long-term care was a richer, more robust, and more complex process, which is distributed, dynamic, collaborative, and continuous, involving multiple health professionals separately performing complementary tasks in different settings over time.
A prototype that demonstrated the feasibility of independent Web-based decision support services interacting in a service-oriented architecture over a network was developed.
This prototype will allow further exploration of the technical issues encountered, such as differences in drug terminologies used in existing systems, speed or access constraints of Web-based knowledge services, inclusion of extraneous data in medication information fields of local systems, and agreement on useful common classification schema for medication information.
Strategic Goal: Develop and disseminate health IT evidence and evidence-based tools to improve the quality and safety of medication management via the integration and utilization of medication management systems and technologies.
This project seeks to provide important information about how to integrate decision support into clinical practices to improve the quality and safety of medication management for people with chronic illnesses.
This project investigates the feasibility and impact of novel approaches to clinical decision support in multidisciplinary ambulatory care, emphasizing high-risk transitions of care.
The project has developed technology to support shared medication management for persons with chronic conditions.
This health IT will be used to facilitate clinician decisionmaking, and improve outcomes for patients and providers in the management of chronic conditions.
Ultimately, the project aims to show improvements in medication management by 1 providing the means to effectively share medication information, 2 making any corrections or improvements made by one team member to the regimen visible to all team members, and 3 providing clinicians using the system with access to evidence-based information at the time and place it is needed.
This project is a continuation of a successful collaboration between community-based nurses and physicians providing ambulatory services in an Oregon coastal community, a multidisciplinary team of university-based investigators with expertise in medicine, nursing, medical informatics, and computer science, and the Oregon Rural Practice-based Research Network, which provides the infrastructure, coordination, and support.
Clinical settings for the project are independent clinic practices in two coastal communities, local home health services, and transitions in care into and out of the single community hospital and its emergency room.
The patient focus is on community-dwelling persons with chronic conditions on multiple medications. The team configured these clients to interact through the versioning system SyncRx and explored the usefulness of this technology in prototype testing, to determine the requirements and challenges to its development and deployment Aim 3.
Refinement of the documentation for the parser function was completed. The prototype for the identifier module underwent trial-and-error testing.
The demonstration included services for parsing, identification using RxNorm , and classification using NDFRT of medication information, and a software harness to allow composition of these and other medication management services.
The project budget was significantly underspent. Funds will be used to underwrite expenses during the no-cost extension.
The project is focusing on analysis of field data and disseminating findings from field observation as well as software tools. She brings significant experience in delivering domestic and international marketing programs for Microsoft and other high-growth companies to identify growth drivers and design marketing strategies and tactics for small and medium sized businesses.
McBane co-chaired the task force that developed state legislation to recognize pharmacists as providers and expand the scope of practice for pharmacists in the state of California.
The MIT Enterprise Forum case study presentations welcome CEOs of local, up and coming, technology companies to present an executive overview, including current challenges facing their business.
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