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Many common medication errors that physicians make result from failure to link clinical laboratory and pharmacy information systems. Linking laboratory and pharmacy information systems could be an effective way to prevent potential drug toxicity and more promptly recognize and address it when it does occur, according to the authors of a new study. For example, a patient with renal insufficiency who is to receive the antibiotic gentamycin could have the dose adjusted more easily.
Such linkages can either be retrospective—linking downloaded laboratory or pharmacy files—or real-time—via emerging intelligent order entry systems. Although most hospitals and health systems do not currently have the capability for real-time linkage, virtually all of them could, but do not, retrospectively tap into existing systems to link laboratory and pharmacy data. By not doing this, hospitals miss improvement opportunities in existing data systems, according to Gordon Schiff, M.D., of Rush Medical College, and his colleagues. Their work was supported in part by the Agency for Healthcare Research and Quality (HS11552).
Dr. Schiff and his colleagues examined opportunities for reducing errors and improving care by linking laboratory and pharmacy information systems. They found that drug therapy could benefit from enhanced laboratory-pharmacy linkage in five areas: one, drug choice (lab-based indications and contraindications); two, drug dosing (dosing or frequency adjustments); three, laboratory monitoring (signals of toxicity, baseline and ongoing monitoring); four, laboratory result interpretation (drug interfering with test), and five, broader quality improvement (surveillance for unrecognized toxicity, monitoring clinician response delays).
See "Linking laboratory and pharmacy: Opportunities for reducing errors and improving care," by Dr. Schiff, David Klass, M.D., Josh Peterson, M.D., and others in the April 28, 2003, Archives of Internal Medicine 163, pp. 893-900.
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