Patients frequently receive prescription refills and may take a medication that was previously discontinued by a clinician due to the pharmacist not receiving notification. An underutilized solution to this problem is the ability to electronically cancel a prescription via the NCPDP CancelRx ePrescribing Standard. The CancelRx standard is required to be present, but not used, in 2015 Meaningful Use Certified EHR products and therefore is not always enabled in clinical care. Even when used by a prescribers EHR system there can be downstream challenges with implementation such as configuration difficulties at EHR and pharmacy systems as well as usability challenges within the prescriber’s workflow. This challenge surfaced while exploring use cases for statewide Health Information Exchange Services in Connecticut. We formed an informal workgroup which grew into a 50-person multi-stakeholder, multi-organizational process that developed shared learning goals, evaluated workflow challenges, reviewed technical standards and reviewed return on investments for implementation. We also piloted CancelRx standards and offered recommendations to our State Legislature and HIT Advisory Board about ways to enhance medication prescribing safety. We will share lessons learned, the impact on the use of CancelRx in CT and the continuation of this work into a larger Medication Reconciliation Polypharmacy workgroup.
Describe the new knowledge and additional skills the participant will gain after attending your presentation.: Participants will:
1) Better understand the CancelRx ePrescribing standard and its role in sucessfully deprescribing medications to avoid patient safety risks
2) Be able to describe the complex process of intertwined issues of clinician workflow, technical standards and return on investment decisions all need to be considered when attempting a broad adoption of the CancelRx messaging standard.
3) Be able to describe how a multi-stakeholder state-wide effort has led to additional efforts to address prescription safety
Thomas Agresta (Presenter)
University of Connecticut School of Medicine
Nitu Kashyap, Yale
Sean Jeffery, University of Connecticut / Hartford Healthcare
Stacy Ward-Charlerie, SureScripts
Sudeep Bansal, Avanta