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(Sponsor: New York Chapter)
WHEREAS, electronic prescribing has improved the process of getting prescriptions delivered more consistently, quickly and legibly to pharmacies by using computer technology effectively; and
WHEREAS, existing computer technology has not included electronic mechanisms to notify the pharmacist when medications are discontinued while refills are still remaining; and
WHEREAS, serious medication safety problems can occur when a medication is dispensed to the patient after the medication has been discontinued, and the pharmacies are unable to prevent such errors because there is no electronic mechanism complementary to the electronic "start" that provides them with an electronic "stop" in the ambulatory setting; and
WHEREAS, clinicians have often had patients refill medications that were supposed to have been stopped for a variety of reasons including: pharmacy automated refill programs, complexities of medication reconciliation, and office communication that result in patients and caregivers requesting refills of discontinued medications; and
WHEREAS, this is a clear patient safety issue that can be significantly prevented by electronically discontinuing medications in the same fashion that medications are ordered because "stop" procedures have not been incorporated routinely into EHRs and have not been defined as a requirement for EHR certification; and
WHEREAS, this issue was highlighted in an Annals of Internal Medicine article entitled "Pharmacy Dispensing of Electronically Discontinued Medications," 20 November 2012, Volume 157, Number 10 700-705; therefore be it
RESOLVED, that the Board of Regents advocates to the National Quality Forum, JCAHO, AHRQ, EHR vendors, and all organizations whose scope includes improving patient safety with respect to pharmaceuticals that all EHR's should include the capability to electronically send "stop" orders to pharmacies and such capability should be required for EHR certification; and be it further
RESOLVED, that the Board of Regents requests other professional physician and pharmacy organizations to support efforts to add prescription stop order capability to all certified Electronic Health Record systems.