FREQUENTLY ASKED QUESTIONS
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1 FREQUENTLY ASKED QUESTIONS What is the Nova Scotia Drug Information System? The Nova Scotia Drug Information System is one of the clinical components of the Electronic Health Record in Nova Scotia (SHARE). The Drug Information System will provide a comprehensive record of all patients prescriptions that are dispensed by community pharmacies in Nova Scotia, as well as, medication related information such as allergies, immunizations and medical conditions. What are the benefits of the Drug Information System? Provides a comprehensive medication profile for patients. Interaction and contraindication checking at the time of prescribing, dispensing or when care decisions are being made. Access to drug information reference material such as drug monographs. Electronic exchange of medication information. Electronic prescribing (e-prescriptions). The overall benefit of the Drug Information System is that it provides information to facilitate safe and appropriate drug therapy for patients. Who will have access to the Drug Information System and how will that access occur? Health care professionals authorized to access to the Drug Information System will depend upon the phase or stream of implementation. An authorized health care provider is a health professional - such as a pharmacist, doctor, dentist, nurse practitioner, optometrist, or midwife - who provides or supports patient care. The Drug Information System will be implemented in three phases or streams: Stream 1 Pharmacy: (Beginning Fall 2013) Dispensary staff (pharmacists, pharmacy technicians and assistants) in community pharmacies will connect to the Drug Information System through their pharmacy software system. Stream 2 Hospitals and Community Prescribers: (Beginning Summer 2015) Hospital and community prescribers and non-prescribers will access the Drug Information System through either the Drug Information System portal the SHARE Clinical Portal. Prescribers such as 1
2 physicians, nurse practitioners, dentists, and optometrists etc. will have access to patient medication profiles and e-prescribing. Stream 3 Electronic Medical Records: (Beginning Spring 2015) Physicians offices and clinics using the provincial electronic medical record systems are expected to be able to begin connecting in the spring of What information is maintained in the Drug Information System? The following types of information will be included in patients medication profile in the Drug Information System: prescription orders dispenses This information can be included in patients medication profile in the Drug Information System if disclosed by the patient and entered by the health care provider: pharmacy professional services (e.g. diabetes education) other medications (e.g. over-the counter medications) drug allergies / intolerances adverse reactions medical conditions patient observations (e.g. height, weight, blood pressure and glucose levels) immunization patient notes How do dispensary staff access the Drug Information System? Dispensary staff will access the Drug Information System through their current pharmacy software system. Staff will be provided with software training by their pharmacy software vendor. Will patients current information be included in the Drug Information System? Information will be entered into the Drug Information System on a go-forward basis only. There will not be an initial load of the patient files currently in pharmacy software systems. Therefore, dispensary staff should enter information about their patients that is important to be included in their medication profile. This could include medical conditions; allergies / intolerances; and other medications. Dispensary staff are encouraged to enter as much information as possible during each patient encounter. The more information entered, the more comprehensive the Drug Information System medication profiles will be. 2
3 Why is patient s health card number or unique identifier needed when using the Drug Information System? As it is unlikely that two people will have the same Nova Scotia Health Card Number, it is best practice is to search using the Health Card Number or other unique identifier (if the person doesn t have an NS Health Card Number). Examples of other unique identifiers are: alternate health identification numbers (e.g. Canadian Forces number); or health card numbers from other provinces. Using a unique identifier to search is more efficient and results in higher accuracy of finding the correct record. Searching using the patient s unique identifier also helps prevent duplicate records in the system. Having only one record per patient will help ensure the accuracy and comprehensiveness of the patient s medication profile in the Drug Information System and help improve patient safety and quality of care. What is e-prescribing? In Stream 2, prescribers will have the ability to e-prescribe authoritatively which means create electronic prescription orders (e-prescriptions) which are transmitted directly to the Drug Information System. Dispensary staff can retrieve these electronic prescription orders from the Drug Information System using their pharmacy software system. The pharmacy can then save the prescription order locally and proceed with the dispense process. Note that until Stream 2 begins, pharmacists can e-prescribe but all e-prescriptions are nonauthoritative, which means you must have a paper copy of the prescription before you can dispense it. Your pharmacy will be notified before e-prescribing is introduced. Why do quantities always show as milligrams in the DIS? The DIS uses a standardized unit of measurement. When displaying weight the standardized unit used is milligrams. This means that when you send a quantity to the DIS in grams, it will be converted to milligrams and displayed in milligrams. For example, a 15 gram tube of hydrocortisone cream 0.05 percent may display in your local pharmacy system at 15 g, however, it will display in the DIS as 15,000 mg. 3
4 What happens if there is an interruption in service within the Drug Information System? The Drug Information System is designed to be available 24 hours a day, 7 days a week, 365 days a year with scheduled maintenance windows. If an unscheduled outage occurs, your system will indicate that it is not connecting with the Drug Information System. See your vendor for further details. While the Drug Information System is down, the local pharmacy system continues to operate and will queue all appropriate transactions to the Drug Information System. Once the connection is restored, all appropriate transactions must be sent to the Drug Information System. It is important that your pharmacy understand the process for processing queued transactions once the Drug Information System is available. What education and training will be available to me before, during and after the implementation of the Drug Information System? Dispensary staff will be provided with both education and training regarding the Drug Information System. Education The educational component will provide an overview of: the functions and benefits of the Drug Information System; the Client and Provider Registries and the Personal Health Information Act (PHIA) along with information about best practices when using the system. It will provide information that is vital to understanding the what and why of the Drug Information System prior to undergoing hands-on training. The main component of education about the Drug Information System for dispensary staff is provided through four e-learning modules that are housed on the Department of Health and Wellness website found at in the Information for Pharmacies Education Resources section. There are also resource documents located on the same website which can be easily accessed for reference purposes after the implementation of the Drug Information System in your pharmacy. These e-learning modules may be completed at your own pace and are available 24 hours a day, 7 days a week. All modules are self-contained and each will take approximately minutes 4
5 to complete. The modules are designed to be completed sequentially but can be accessed and completed in any order. Training The training aspect will provide information about the how of the Drug Information System: how you enter certain information; how you conduct searches etc. Your pharmacy software vendor will provide you with specific hands-on training on their particular software. It is recommended that you complete the online e-learning modules prior to commencing the software training. 5
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Heidi S. Daniels, PharmD Pharmacist Informaticist NEFSHP Fall Meeting: Pharmacy Practice Updates 2015 Daniels.Heidi@mayo.edu Mayo Clinic Florida Campus Jacksonville, Florida I have nothing to disclose