Back in December, Drug Topics published Kroger pharmacy’s shared EHR pilot project a success, which described a study completed by an Ohio chain and a local family practice provider. The essence of this study was to observe the benefit of giving a select pharmacy access to the medical provider’s Electronic Health Record (EHR).

This study was certainly not unique, though. Many pharmacies have created similar collaborations. Our pharmacy, for example, has access to our shared patients with a local hospice and a nursing home. The advantages described in Drug Topics are certainly real. Access to a this additional information enables the pharmacist to better ensure that patient is receiving the most effective and safe therapy, and that the desired outcomes are met.

But not all is rosy in these scenarios. The current lack of integration between pharmacy management systems and EHR of the office or organization creates an extra step in the clinical workflow for the pharmacist. Any documentation the pharmacist has to make must be made both in the EHR and the pharmacy management system.

The problem is not limited to the exchange of information between the pharmacy and the office. Collaboration between general practitioners and specialists is hampered by the lack of communication between different vendor’s EHR implementations. This single fact represents one of the biggest reasons that the facsimile (fax) still remains a predominant tool in healthcare. Paper is a common denominator as the document can be scanned into the EHR.

Our Experience with the EHR

In our pharmacies, or employees regularly have multiple systems running on their workstations. This includes our pharmacy management system, our clinical management system (PharmClin), MTM management systems like Mirixa and Outcomes, and multiple EHR windows for the offices with which we routinely collaborate. This requires significant attention to detail and a bit of computer savvy.

Any given problem found by our pharmacists is entered into at least two different systems. Fortunately, many of these systems are free-text based, and our pharmacists can simply copy and paste information between applications to minimize the extra work required to complete documentation on all platforms.

A bigger problem, however, is the reciprocal communication channel. The doctors and nurses at the remote offices do not have a way to easily pull information from the pharmacy’s prescription system. The most common information prescribers are interested in is an accurate medication profile. In lieu of a two way exchange, a copy of the patient’s medication profile with all of our notes by our clinical documentation system (PharmClin).

Despite the challenges of working with multiple EHR products, the benefits still far exceed the associated cost. The improved communication allows our pharmacists to better identify problems in the patient’s drug therapy, monitoring plans and therapeutic goals.

As we continue to navigate the currently evolving transition in pharmacy toward a care centered model, we are continuing to look for new ways to improve communication with the providers. This means that we are constantly connecting with the providers in an attempt to improve our communication.