al., 2005), which in turn requires a defined set of clinical data—the patient’s age, gender, allergies, other medications, problems, and selected laboratory results. Thus to achieve major safety benefits, electronic prescribing should be linked with electronic health records. It should be carried out using a device such as a desktop, laptop, or tablet computer. To date, it has been impossible to deliver adequate clinical decision support on palm-top platforms, primarily because of the infeasibility of incorporating sufficient clinical information in these devices in a timely fashion, the shortage of space on palm-top screens, lack of interoperability, and issues related to transmission speed. The tablet PC provides more screen space than the palm-top device at the cost of some portability.

MULTIDISCIPLINARY TEAMS

Providers should have the appropriate competencies for each step of the medication-use process.

The use of multidisciplinary teams to care for patients receiving complex medication regimens offers the potential to improve substantially the quality of drug therapy and reduce the occurrence of medication errors and ADEs (Leape et al., 1999). Such teams may include nurses, clinical pharmacists, and other health professionals, complementing and extending the efforts of the physician. In most instances, it is useful to enlist the patient and family members as part of the overall team. In certain instances, having specific individuals on the team can be beneficial. For example, having a pharmacist conduct rounds with the team has been found to reduce ADE rates in the intensive care unit setting (Leape et al., 1999). While it probably does not make sense to have pharmacists present during rounds with all teams because of the cost of their services, their input on teams providing care that involves high medication use (for example, chemotherapy units) is likely to provide important benefit.

Multidisciplinary approaches have been employed to optimize pharmacotherapeutic management of patients across a variety of clinical settings, from the intensive care unit to the ambulatory setting. These approaches have often focused on specific medical conditions, such as diabetes mellitus and congestive heart failure (Rich et al., 1995; Whellan et al., 2005), or specific drug therapies, such as anticoagulant therapy.

Cohesive health care teams possess five key characteristics (Grumbach and Bodenheimer, 2004):

  • Clear goals with measurable outcomes

  • Clinical (e.g., for prescription refills) and administrative (e.g., for making patient appointments) systems



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