The following HTML text is provided to enhance online
readability. Many aspects of typography translate only awkwardly to HTML.
Please use the page image
as the authoritative form to ensure accuracy.
Patient Safety: Achieving a New Standard for Care
TABLE 6-3 Computerized Physician Order Entry Validation Modules for Medication Prescribing
Validation Module
Generic Data Requirements
Therapeutic duplication
Medications, medication ingredients
Single and cumulative dose limits
Medications, dose levels
Allergies and cross-allergies
Allergies, drug allergies
Contraindicated route of administration
Medications, route of administration
Drug–drug and drug–food interactions
Medications
Contraindication/dose limits based on patient diagnosis
Medications, diagnoses
Contraindication/dose limits based on patient age and weight
Contraindication/dose limits based on radiology studies
Medications, contrast media used in radiology
SOURCE: Kilbridge et al., 2001.
tion and the patient’s existing medications. To do this requires data on all the patient’s medications and the ingredients of each.
A list of validation modules that could be incorporated in a computerized physician order entry system is given in Table 6-3, together with the generic data requirements. A full set of validation modules requires a wide range of data elements: medications (including ingredients, dose levels, and administration routes), allergies (including drug allergies), diagnoses, patient age, weight, laboratory results, and contrast media used in radiology.
Implications for Data Standards
The various approaches to adverse event detection discussed above demonstrate that it is not possible to simply identify a small set of clinical data elements specifically for adverse event detection, especially when addressing potential injuries due to errors of omission as well as injuries due to errors of commission. On the contrary, a broad range of data elements encompassing demographic information, signs and symptoms, medications, test results, diagnoses, therapies, and outcomes are required to: (1) detect adverse events through voluntary and mandatory reporting, chart review, and automated surveillance; (2) implement performance measures (e.g., DQIP measures);