chc_20152. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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1
Learning Record Transfer
• Transfer Learning Record from CLM to uLearn
• If you have not already done this.
• https://ulearn.cerner.com
• Sign in with your Cerner Care email address and password.
• Follow instructions on main page.
• If you have questions about your learning record, please contact
LearningSolutions@Cerner.com
3. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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2
Objectives
• Understand clinical alerts
• Understand meaningful alerts
• Be able to use the functionality within
medication clinical decision support (mCDS) to
create meaningful alerts
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3
Agenda
• mCDS Introduction
• Venue of Care Filtering
• Preferences
• Customization
• Drug Allergies
• Drug Drug
• Duplication Checking
• Repeat Numbers
• Using Discern Rules
• Discern alerts displayed within mCDS
• Filtering drug drug interactions using discern rules
• Order Detail Filtering
• TPNs
• Alert Maintenance
• Questions/Examples
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4
Scheduled Break Times
• After Venue of Care Filtering
• Lunch
• Noon
• Snack
• 2:10
• PRN
7. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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6
mCDS Objective
Is that Cerner solutions no longer
filters medication alerts that are a
nuisance, but create meaningful
alerts that enhance safety and
improve patient care.
8. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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7
Documentation for mCDS
• All About Medication Clinical Decision Support
• Dashboard Reference Pages PharmNet Inpatient
Reference Pages All About Medication Clinical Decision
Support
• https://wiki.ucern.com/display/public/reference/All+About+Med
ication+Clinical+Decision+Support
• Go under the additional information hyperlink
• Medication Clinical Decision Support (mCDS) Scenarios Build
• Venue of Care Filtering PowerPoint
• mCDS – Making Clinical Alerts Meaningful
• uCern Medication Clinical Decision Support (mCDS)
• https://connect.ucern.com/groups/medication-clinical-decision-
support-mcds
9. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
8
Documentation for mCDS
• All About Medication Clinical Decision Support
• Dashboard Reference Pages PharmNet Inpatient
Reference Pages All About Medication Clinical Decision
Support
• https://wiki.ucern.com/display/public/reference/All+About+Med
ication+Clinical+Decision+Support
• Go under the additional information hyperlink
• Medication Clinical Decision Support (mCDS) Scenarios Build
• Venue of Care Filtering PowerPoint
• mCDS – Making Clinical Alerts Meaningful
• uCern Medication Clinical Decision Support (mCDS)
• https://connect.ucern.com/groups/medication-clinical-decision-
support-mcds
10. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
9
Documentation for mCDS
• All About Medication Clinical Decision Support
• Dashboard Reference Pages PharmNet Inpatient
Reference Pages All About Medication Clinical Decision
Support
• https://wiki.ucern.com/display/public/reference/All+About+Med
ication+Clinical+Decision+Support
• Go under the additional information hyperlink
• Medication Clinical Decision Support (mCDS) Scenarios Build
• Venue of Care Filtering PowerPoint
• mCDS – Making Clinical Alerts Meaningful
• uCern Medication Clinical Decision Support (mCDS)
• https://connect.ucern.com/groups/medication-clinical-decision-
support-mcds
11. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
10
Documentation for mCDS
• All About Medication Clinical Decision Support
• Dashboard Reference Pages PharmNet Inpatient
Reference Pages All About Medication Clinical Decision
Support
• https://wiki.ucern.com/display/public/reference/All+About+Med
ication+Clinical+Decision+Support
• Go under the additional information hyperlink
• Medication Clinical Decision Support (mCDS) Scenarios Build
• Venue of Care Filtering PowerPoint
• mCDS – Making Clinical Alerts Meaningful
• uCern Medication Clinical Decision Support (mCDS)
• https://connect.ucern.com/groups/medication-clinical-decision-
support-mcds
12. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
11
Documentation for mCDS
• All About Medication Clinical Decision Support
• Dashboard Reference Pages PharmNet Inpatient
Reference Pages All About Medication Clinical Decision
Support
• https://wiki.ucern.com/display/public/reference/All+About+Med
ication+Clinical+Decision+Support
• Go under the additional information hyperlink
• Medication Clinical Decision Support (mCDS) Scenarios Build
• Venue of Care Filtering PowerPoint
• mCDS – Making Clinical Alerts Meaningful
• uCern Medication Clinical Decision Support (mCDS)
• https://connect.ucern.com/groups/medication-clinical-decision-
support-mcds
13. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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12
Packages
• mCDS package
• Innovations Dev (US): Medication Clinical Decision Support
Window
• Need 83848 or higher
• MultumCustom.exe
• Need 68066 or higher
14. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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13
Nuisance Alerts
• Not unique to Cerner solutions
• Have seen studies where up to 85% of the alerts are
ignored
• Not unique to drug content provider
• Cerner Multum
• FDB (First Databank)
• Medi-Span
• Varies across venues of care
• Ambulatory vs. Inpatient
15. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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14
What’s the cause of nuisance alerts?
• Conservative nature of content produced by
commercial vendors
• Cerner Multum/FDB/Medi-Span
• Lack of context from not considering available data,
objectives, role, and venue of care
16. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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15
Approach to reducing nuisance alerts has been to
reduce the “noise”, not to make them meaningful
• Turn alerting off
• Mainly drug drug and duplicate therapy
• Leave allergy checking on
• Disable lower severity alerts
• “Fine tune” higher severity alerts
• Government recommendations (FDA)
21. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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20
mCDS Development Approach
• Improve the user experience
• Enhance the user interface
• Address major functional gaps/limitations
• Improve ability to “localize” the experience
• Required changes and “tightening”
• Meaningful use
• “Bugs”/Client feedback
• Incorporate Discern capabilities
• Filter alerts based upon order details
• Existing ADE packages, local rules
• Utilize future Cerner capabilities
• Cerner Math
• DAAKOS
• Hansten and Horn
22. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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21
Meaningful Use
• Stage 1
• Drug allergy checking
• Drug drug interaction checking
• Stage 2
• Citations
• Allergies
• Drug Interactions
• Requirements
• mCDS window
• Latest/Greatest Cerner Multum content package
• Stage 3
• Cerner working on requirements
25. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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24
Drug Drug Interaction Citation
• Select icon next to the drug interaction pair to display
26. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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25
AHS_FL Alert Reduction since implementing
mCDS Window
28. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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27
Window Improvements
• Window defaults to all sections open – ability to
collapse individual sections or all sections
• Triggering and existing medications display honors
MNEM_DISP_LEVEL preference
• Additional order information available via order detail
tool tip
• Triggering and existing medications display Simplified
Display Line
• Drug reference, patient leaflets, and alert history
accessed from hyperlink on medication order
• Ability to discontinue medication being ordered and
profile medication from the mCDS window
29. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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28
Window Improvements
• Ability to identify orders as historical, prescription, or
an inpatient medication order
• Severity level of interaction is displayed in text, not an
icon, with Major Contraindicated interactions color
coded in red
• Access additional interaction information via a
hyperlink
• Allergy and drug drug interaction citation information
available
30. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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29
Allergy Improvements
• Access allergy control via a hyperlink
• Allergy Comments, Reaction Type, and Information
Source are displayed
• Allergy Citation information is available – Meaningful
Use requirement
31. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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30
Override Reasons Improvements
• Override Reason selection available for individual
alerts
• Previous Override Reason is available
• “Apply to All” Override Reasons configurable in
Bedrock
32. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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31
mCDS Alert Override Reasons
• Design Decisions
• Not Required
• Required
• Which application(s)
• Which alert type(s)
• Which provider(s)
• Which individual(s)
• Configure in PrefMaint.exe
• PowerChart Chart PowerOrders
• MUL_OVERRIDEREQUIRED (0 =Override Reason not required; 1=
Override Reason Required)
• MUL_OVERRIDEREQUIRED_TYPE
• Pharmacy
• MUL_OVERRIDEREQUIRED_TYPE
• Bedrock
• Override Reason filters for All Alert Types and each specific Alert Type
33. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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32
Requiring Override Reasons in PowerChart
• Configure in PrefMaint.exe
• PowerChart Chart PowerOrders
MUL_OVERRIDEREQUIRED and
MUL_OVERRIDEREQUIRED_TYPES
34. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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33
Requiring Override Reasons in Med
Manager
• Configure in PrefMaint.exe
• Pharmacy MUL_OVERRIDEREQUIRED_TYPES
35. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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34
Override Reasons Display
• Bedrock Override Reasons Filters
• In order for an Override Reason to be available for “Apply to
All” it must be included in the “Override Reason for all Types”
filter
36. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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35
mCDS Discontinue Reasons
• Design Decisions
• Not Required
• Required
• What reasons to display
• Configure
• DCPTools.exe Order Management Order Entry Format
Tool Formats Pharmacy Order Entry Formats
Discontinue Order Action Discontinue Reasons Field
• Discontinue format build is required or mCDS window will
display an error
• Selections for field: Do Not Display, Display Only, Optional,
Required
37. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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36
Discontinue Reason Format
Selections for field: Do Not
Display, Display Only, Optional,
Required
38. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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37
mCDS Discontinue Reasons
• Must use code set 1309 for the drop down
• DCPTools.exe Order Management Order Entry Format
Tool Fields Discontinue Reason
• Must use Meaning of Discontinue Reason
39. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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38
Filtering Discontinue Reasons
• Configure in Bedrock
• Design, Build and Maintenance Core – Orders Order Entry
Field Value (Code Set) Filtering Discontinue Reason (Code Set
1309)
• Catalog Type
• Activity Type
• Orderable
41. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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40
Agenda for Venue of Care Filtering
• Description
• Diagrams
• Diagrams – a second time
• How to set up
• Example
• Questions????
42. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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41
Documentation for mCDS
• All About Medication Clinical Decision Support
• Dashboard Reference Pages PharmNet Inpatient
Reference Pages All About Medication Clinical Decision
Support
• https://wiki.ucern.com/display/public/reference/All+About+Med
ication+Clinical+Decision+Support
• Go under the additional information hyperlink
• Medication Clinical Decision Support (mCDS) Scenarios Build
• Venue of Care Filtering PowerPoint
• mCDS – Making Clinical Alerts Meaningful
• uCern Medication Clinical Decision Support (mCDS)
• https://connect.ucern.com/groups/medication-clinical-decision-
support-mcds
43. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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42
Venue of Care Filtering
• Definition
• Filtering of all alert types (drug drug, drug food, drug allergies,
and duplicate therapy) when moving from home
(prescriptions) to inpatient and back to prescriptions.
• Rationale for filtering alerts
• Reduction of nuisance alerts when patients move across
venues of care (prescriptions (home) to inpatient to
prescriptions).
• Customization
• Bedrock mCDS wizard
44. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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43
Venue of Care Filtering
• Applies to all alert types
• Drug Drug
• Drug Food
• Drug Allergy
• Duplicate Therapy
• Filters are in Bedrock
• Code set extension settings in CoreCodeBuilder.exe no longer
honored
• Home Medication to Inpatient Filtering (HXIP)
• Inpatient Filtering (IP)
• Inpatient to Prescription Filtering (IPRX)
• Prescription Filtering (RX)
• Filtering applies to all solutions and position codes
45. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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44
Venue Filters Off
• When all venue of care filters are off, checking will
occur across documented home medications, inpatient
orders, and prescription orders.
46. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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45
Venue of Care Filtering
• Venue of Care Filtering
47. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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46
Venue of Care Filtering -- HXIP
• No alerts
• HXIP filtering on – No checking against medications when moving
from home meds to inpatient orders
• potassium chloride and diphenhydrAMINE drug drug interaction suppressed
• diphenhydrAMINE and loratadine duplicate checking suppressed
• same orderable duplicate checking suppressed
• This filter will always occur across solutions
HXIP Alerts Filtered
48. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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47
49. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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48
Venue of Care Filtering -- IP
• No alerts
• IP filtering on – No checking between medications continued
as inpatient orders
• Potassium chloride and diphenhydrAMINE drug drug interaction
suppressed
• diphenhydrAMINE and loratadine duplicate checking suppressed
• One time blocking
• Second time (e.g., verification by pharmacy) will see this alert
IP Alerts Filtered
50. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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49
51. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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50
Venue of Care Filtering -- IPRX
• No alerts
• IPRX filtering on – No checking against inpatient medications when
moving from inpatient meds to prescription orders
• This filter will always occur across solutions IPRX Alerts Filtered
52. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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51
53. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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52
Venue of Care Filtering -- RX
• No alerts
• RX filtering on – No checking between inpatient medications
continued as prescription orders
Alert Checking does occur for medications that were not continued from
inpatient order – hydrOXYzine was not an inpatient medication
• One time blocking
• Second time will see this alert RX Alerts Filtered
54. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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53
55. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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54
56. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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55
Venue of Care Filtering
• Venue of Care Filtering
57. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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56
Venue of Care Filtering
• Bedrock.exe Quality Reporting and MPages MPage Setup
Medication Clinical Decision Support (mCDS)
58. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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57
Venue of Care Filtering
• Home Medication to Inpatient Filtering
59. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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58
Venue of Care Filtering
• Home Medication to Inpatient Filtering
• This setting determines if clinical checking will be filtered
between history and inpatient venues. This filter will be used
when an order moves from history to inpatient
venue(s) of care or an inpatient order is placed.
60. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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59
Venue of Care Filtering
• Home Medication to Inpatient Filtering
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60
CoreCodeBuilder.exe
62. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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61
Venue of Care Filtering
• Inpatient Filtering
• This setting is used to determine how clinical checking is
filtered during the patient’s inpatient stay. If enabled, one-time
blocking of clinical checking (drug drug, drug food, drug
allergy, duplicate therapy) will occur within the “inpatient”
venue of care.
63. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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62
Venue of Care Filtering
• Inpatient Medication Filtering
64. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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63
Venue of Care Filtering
• Inpatient to Prescription
• This setting determines if clinical checking will be filtered
between inpatient and discharge venues. This filter will be
used when an order moves from inpatient to discharge
venue(s) of care or an inpatient or prescription order is placed.
65. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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64
Venue of Care Filtering
• Inpatient to Prescription Filtering
66. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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65
Venue Filtering
• Prescription Filtering
• This setting is used to determine how clinical checking is
filtered when prescriptions are prescribed. If enable, one-time
blocking of clinical checking (drug drug, drug food, drug
allergy, duplicate therapy) will occur within the discharge
venue of care.
67. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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Venue of Care Filtering
• Prescription Filtering
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Venue of Care Filtering
• Example
• HXIP – On
• IP – On
• IPRX – On
• RX – On
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68
70. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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69
Venue of Care Filtering
• No alerts
• No duplicate checking against the same medications because
of HXIP from hx meds to inpatient orders
• IP blocked inpatient orders
• Potassium chloride and diphenhydrAMINE drug drug interaction
• diphenhydrAMINE and loratadine duplicate checking
71. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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70
Venue of Care Filtering
• Alert when ordering potassium chloride IV
• Potassium chloride IV was not a hx med therefore it checked
against all current inpatient orders
72. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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71
Venue of Care Filtering
• Orders to be verified by pharmacy
• The one time blocking has occurred in PowerChart therefore
there will not be any IP blocking when verifying
• If orders are entered directly in PharmNet then the one time
blocking of IP will apply
73. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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72
Venue of Care Filtering
• Alert with diphenhydrAMINE and potassium chloride IV
• The one time blocking has occurred in PowerChart therefore
there will not be any IP blocking when verifying
• If orders are entered directly in PharmNet then the one time
blocking of IP will apply
74. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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73
Venue of Care Filtering
• Alert for loratadine and diphenhydrAMINE
• The one time blocking has occurred in PowerChart therefore
there will not be any IP blocking when verifying
• If orders are entered directly in PharmNet then the one time
blocking of IP will apply
75. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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74
Venue of Care Filtering
• Alert when verifying potassium chloride IV
• Potassium chloride IV was not a hx med therefore it checked against
all current inpatient orders
76. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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75
Venue of Care Filtering
• Pharmacy orders are verified
77. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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76
Venue of Care Filtering
• Discharging the patient
• No alerts
• No duplicate checking against the same medications because
of IPRX from inpatient meds to prescription orders
• RX blocked prescription orders
• Potassium chloride and diphenhydrAMINE drug drug interaction
• diphenhydrAMINE and loratadine duplicate checking
78. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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77
Venue of Care Filtering
• Alert against the home medication hydrOXYzine and
diphenhydrAMINE
• hydrOXYzine was a hx med and not an inpatient medication therefore
it will be checked against prescription medications
79. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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78
Venue of Care Filtering
• Alert against the home medication hydrOXYzine and
loratadine
• hydrOXYzine was a hx med and not an inpatient medication
therefore it will be checked against prescription medications
80. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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79
Venue of Care Filtering
• Alert against the home medication hydrOXYzine and
potassium chloride
• hydrOXYzine was a hx med and not an inpatient medication
therefore it will be checked against prescription medications
81. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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80
Documentation for mCDS
• All About Medication Clinical Decision Support
• Dashboard Reference Pages PharmNet Inpatient
Reference Pages All About Medication Clinical Decision
Support
• https://wiki.ucern.com/display/public/reference/All+About+Med
ication+Clinical+Decision+Support
• Go under the additional information hyperlink
• Medication Clinical Decision Support (mCDS) Scenarios Build
• Venue of Care Filtering PowerPoint
• mCDS – Making Clinical Alerts Meaningful
• uCern Medication Clinical Decision Support (mCDS)
• https://connect.ucern.com/groups/medication-clinical-decision-
support-mcds
82. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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81
Venue of Care Filtering
• Venue of Care Filtering
• Questions????
83. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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82
“Mr. Osborne,
may I be
excused?
My brain is full.”
85. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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84
86. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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85
MULPREF
• Turns on Multum within Matrix Orders.
• 1-On
• 0-Off
87. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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86
MUL_DS_STYLE
• This preference determines the style of the
interaction checking window.
• 1-Use enhanced window
• 0-Use classic window
88. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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87
MUL_MPAGE_VIEW
• Determines if the Medication Clinical Decision
Support (mCDS) view is enabled for Multum
interaction checking. When the value is set to
1 or 2, the preference MUL_DS_STYLE=1
(Use Enhanced View) must also be set.
• 1-On for Add Order or Product
• 0-Off
• 2-On for Sign Order or OK
89. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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88
MUL_OVERRIDEREQUIRED
• This preference determines whether an
Override Reason must be entered in order to
close the alert window.
• 1-Override reason required
• 0-Override reason not required
90. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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89
MULINTR
• This preference determines whether to
perform interaction checking when medication
orders are placed using Matrix Orders.
• 1-Interaction checking
• 0-No interaction checking
91. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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90
MUL_INTRSEVERITY
• This preference determines at what level
interaction checking will occur.
• 5-Major Contraindicated
• 3-Major
• 2-Moderate
• 1-Minor
92. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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91
MUL_INTERPRETEDSEVERITY
• This preference determines if interaction
checking should be performed based on
traditional Multum severities or on interpreted
severities using the interaction severity and
interaction severity heading. Note that any
customized severities will override the
interpreted severity.
• 0-Use traditional Multum severities
• 1-Use interpreted severities
93. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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92
MULREAT
• This preference determines whether to
perform allergy checking for medication orders
using Matrix Orders.
• 1-Allergy checking
• 0-No allergy checking
94. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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93
MUL_ALLERGYINTERRUPTION
• Determines whether to display the interaction
checking window for allergy reactions.
• 0-Display
• 1-Do not display
95. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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94
MUL_ALLERGY_REACTIONCLASS_FILTER
• This preference determines which types of
allergy reaction class's should be filtered out of
drug-allergy and reverse allergy interaction
checking. This preference is only used when
MUL_DS_STYLE is set to 1.
• The preference is a comma-separated list of
allergy reaction class codes from code set
12021. For example “3291,3292”
• Adverse Effect
• Side Effect
96. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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95
MULDUP
• This preference determines whether to
perform duplicate checking when medication
orders are placed using Matrix Orders.
• 1-Duplicate checking
• 0-No duplicate checking
97. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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96
MUL_DUPINTERRUPTION
• This preference determines whether the
interaction checking window will display when
ordering duplicate medications.
• 0-Display
• 1-Do not display
98. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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97
MULDUPCHECKPREF
• This preference determines the manner in
which duplicate checking is performed for
Pharmacy orders.
• 2-Dups against both
• 0-Dups against scratchpad
• 1-Dups against existing orders
• 3-Dups against scratchpad minus same CKI’s
• 4-Dup against sp minus same cki and existing
99. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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98
MULDUPMODE
• This preference determines when the
duplicate checking window will display.
• 2-Both
• 0-Single Drug
• 1-Category
100. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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99
MULDUPCAT
• This preference determines the level of
duplicate checking when different drugs have
identical or similar clinical effects. This
preference is only used when MULDUPMODE
is set to Category or Both.
• C-Very Specific
• B-General
• A-Very General
101. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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10
0
MULDUPCLASS
• This preference determines whether duplicate
therapy checking should be applied across
both inpatient and outpatient drugs or to check
exclusively inpatient or outpatient drugs.
• 1-Mutually Exclusive
• 0-All
103. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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10
2
104. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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10
3
MultumCustom.exe
Drug Drug Interaction
• Severity
• Severity Header
• Suppression
• Text
Duplicate Therapy Checking
• Repeat Numbers – Must have package number 68066 or higher
installed
• Duplication Category
• Drug
• Suppression
• Duplication Category
• Drug
Drug Allergy Checking
• Drug to Drug
• Allergy Category to Drug
Reference Text
105. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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10
4
Duplicate Therapy
• Suppression
•Duplication Category
• Drug
• Repeat Number
• Duplication Category
• Drug
106. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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10
5
Duplication Therapy Searches
Drug
• Individual drug
Category
• All individual drugs within a drug category
Duplication Category
• The actual duplication category
107. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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10
6
Duplicate Therapy
• Example
• Laxatives
• All About Medication Clinical Decision Support
• Dashboard Reference Pages PharmNet Inpatient
Reference Pages All About Medication Clinical
Decision Support
• https://wiki.ucern.com/display/public/reference/All+About
+Medication+Clinical+Decision+Support
• Go under the additional information hyperlink
• Medication Clinical Decision Support (mCDS) Scenarios Build
• Venue of Care Filtering PowerPoint
• mCDS – Making Clinical Alerts Meaningful
108. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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10
7
Drug Allergy
• Allergy Category
• Suppression of documented allergy
category
• Additional searches
• Allergy Category Drug
• The documented allergy category to a drug
• Allergy Category Category
• The documented allergy category to all individual drugs within a drug category
109. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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10
8
Drug Allergy
Drug Drug
• Individual drugs
• e.g. oxyCODONE / meperidine
Category Drug
• All individual drugs within a drug category to a drug
• e.g. penicillins / aztreonam
Category Category
• All individual drugs within categories
• e.g. loop diuretics / sulfonamides
Allergy Category Drug
• The documented allergy category to a drug
• e.g. penicillins / aztreonam
Allergy Category Category
• The documented allergy category to all individual drugs within a
drug category
• e.g. loop diuretics / Sulfa drugs
110. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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10
9
Drug Allergy
• Example
• Sulfa Drugs and Loop Diuretics
• All About Medication Clinical Decision Support
• Dashboard Reference Pages PharmNet Inpatient
Reference Pages All About Medication Clinical
Decision Support
• https://wiki.ucern.com/display/public/reference/All+About
+Medication+Clinical+Decision+Support
• Go under the additional information hyperlink
• Medication Clinical Decision Support (mCDS) Scenarios Build
• Venue of Care Filtering PowerPoint
• mCDS – Making Clinical Alerts Meaningful
111. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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11
0
Drug Allergy Suppression Client Example
Suppression
loop diuretics (category) / sulfonamides (category)
loop diuretics (category) / sulfa drugs (allergy category)
loop diuretics (category) / sulfonamides (allergy category)
loop diuretics (category) / COX-2 inhibitors (category)
penicillins (allergy category) / aztreonam (drug)
penicillins (category) / aztreonam (drug)
codeine (drug) / meperidine (drug)
codeine (drug) / fentanyl (drug)
morphine (drug) / meperidine (drug)
oxyCODONE (drug) / meperidine (drug)
oxyCODONE (drug) / fentanyl (drug)
fentaNYL (drug) / HYDROmorphone (drug)
meperidine (drug) / acetaminophen-oxycodone (drug)
meperidine (drug) / HYDROmorphone (drug)
acetaminophen-propoxyphene (drug) / HYDROmorphone (drug)
acetaminophen-propoxyphene (drug) / acetaminophen-oxycodone (drug)
acetaminophen-hydrocodone (drug) / meperidine (drug)
nalbuphine (drug) / meperidine (drug)
carbapenems (category) / third generation cephalosporins (category)
112. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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111
Drug Allergy Suppression Most Questioned/Reviewed
Sulfonamides and Related Compounds Classification
carbonic anhydrase inhibitor sulfonylurea sulfonamide
d00161 acetaZOLAMIDE d00162 acetoHEXAMIDE d04428 amprenavir
d04301 brinzolamide ophthalmic d00042 chlorproPAMIDE d04301 brinzolamide ophthalmic
d00639 dichlorphenamide d03864 glimepiride d04380 celecoxib
d03805 dorzolamide ophthalmic d00246 glipiZIDE d05825 darunavir
d00640 methazolamide d00248 glyBURIDE d00129 diazoxide
sulfa topical d00393 TOLAZamide d04901 fosamprenavir
d01258 mafenide topical d00394 TOLBUTamide d00031 probenecid
d01259 silver sulfADIAZINE topical thiazide or thiazide-like diuretic d08182 simeprevir
d01208 sulfacetamide sodium ophthalmic d00641 bendroflumethiazide d00118 sulfADIAZINE
d01265 sulfacetamide sodium topical d00644 benzthiazide d03742 sulfadoxine
d01240 sulfanilamide topical d00190 chlorothiazide d01090 sulfamethizole
d03980 sulfiSOXAZOLE ophthalmic d00253 hydrochlorothiazide d00119 sulfamethoxazole
d03231 triple sulfa topical d00645 hydroflumethiazide d00379 sulfaSALAzine
sulfonamide-type loop diuretic d00260 indapamide d00120 sulfiSOXAZOLE
d00179 bumetanide d00643 methyclothiazide d07942 sulfonated phenolics topical
d00070 furosemide d00647 polythiazide d04121 tamsulosin
d03189 torsemide d00646 trichlormethiazide d05538 tipranavir
sulfone thiazide-like diuretic d04778 valdecoxib
d00098 dapsone d00192 chlorthalidone d04527 zonisamide
d05543 dapsone topical d00299 metolazone
113. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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11
2
Drug Allergy Suppression Most Questioned/Reviewed
Penicillins and Related Drugs Classification
beta lactamase inhibitor cephalosporin
d04405 clavulanate d00081 cefaclor
d04403 sulbactam d00080 cefadroxil
d04404 tazobactam d00062 cefamandole
carbapenem d00007 ceFAZolin
d07049 doripenem d04256 cefdinir
d04783 ertapenem d04767 cefditoren
d04401 imipenem d03882 cefepime
d04027 meropenem d00072 cefixime
monobactam d00093 cefmetazole
d00067 aztreonam d00063 cefonicid
penicillin d00074 cefoperazone
d00088 amoxicillin d00008 cefotaxime
d00003 ampicillin d00055 cefoTEtan
d00151 bacampicillin d00094 cefOXitin
d00092 carbenicillin d00095 cefpodoxime
d00152 cloxacillin d00073 cefprozil
d00153 dicloxacillin d07706 ceftaroline
d00107 methicillin d00009 cefTAZidime
d00109 mezlocillin d03874 ceftibuten
d00029 nafcillin d00010 ceftizoxime
d00115 oxacillin d00052 cefTRIAXone
d00116 penicillin d00056 cefuroxime
d07727 penicillin G benzathine d00096 cephalexin
d07729 penicillin G potassium d00186 cephalothin
d07728 penicillin G sodium d00187 cephapirin
d07730 penicillin V potassium d00053 cephradine
d00057 piperacillin d00105 loracarbef
d07390 procaine penicillin
d00121 ticarcillin
114. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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11
3
Drug Allergy Suppression Most Questioned/Reviewed
Narcotic Analgesics Classification
methadone-like opiate phenanthrene derivative
d03187 levomethadyl acetate d04991 apomorphine
d00050 methadone d00840 buprenorphine
d00360 propoxyphene d00838 butorphanol
opioid-like analgesic d04251 butorphanol nasal
d03826 traMADol d00012 codeine
phenylpiperidine derivative d00837 dezocine
d00167 alfentanil d03168 dihydrocodeine
d03069 difenoxin d03877 heroin (Schedule I substance)
d03071 diphenoxylate d03075 HYDROcodone
d00233 fentaNYL d00255 HYDROmorphone
d04313 fentanyl topical d00825 levorphanol
d00017 meperidine d00308 morphine
d04034 remifentanil d05295 morphine liposomal
d00378 SUFentanil d00839 nalbuphine
d00824 opium
d00329 oxyCODONE
d00833 oxymorphone
d00334 pentazocine
115. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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11
4
Drug Drug
• Suppression
• Severity
• Major
• Moderate
• Minor
• Header Severity
• Contraindicated
• Major and Contraindicated is the major contraindicated
preference
• Generally Avoid
• Monitor Closely
• Adjust Dosing Interval
• Adjust Dose
• Additional Contraception Recommended
• Monitor
• Monograph Text
116. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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11
5
Drug Drug
Drug Drug
• Individual drugs
Category Drug
• All individual drugs within a drug category to a drug
Category Category
• All individual drugs within categories
117. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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11
6
Drug Drug
• Example
• Customizing to Major Contraindicated
• All About Medication Clinical Decision Support
• Dashboard Reference Pages PharmNet Inpatient
Reference Pages All About Medication Clinical
Decision Support
• https://wiki.ucern.com/display/public/reference/All+About
+Medication+Clinical+Decision+Support
• Go under the additional information hyperlink
• Medication Clinical Decision Support (mCDS) Scenarios Build
• Venue of Care Filtering PowerPoint
• mCDS – Making Clinical Alerts Meaningful
119. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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11
8
Filtering Medication Alerts Using Discern Expert
• Apply Discern Expert rules to interaction pairs
• Display additional information
• Suppress alerts based on patient parameters
• The Discern Expert rule is built in Discern EKM
Development application available in Discern Launch
• Evoke MUST be SYNCHEVENT
• Rule firing will not result in the mCDS window displaying;
result will display when other alert types involving the
interaction pair have fired, displaying the window
• The Expert Synch trigger is included in multumcustom.exe
120. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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11
9
121. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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12
0
122. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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12
1
Filtering Medication Alerts Using Discern Expert
• Examples
• Suppression drug drug interactions based on lab values
• Displaying Lab Values
• All About Medication Clinical Decision Support
• Dashboard Reference Pages PharmNet Inpatient
Reference Pages All About Medication Clinical Decision
Support
• https://wiki.ucern.com/display/public/reference/All+About+Med
ication+Clinical+Decision+Support
• Go under the additional information hyperlink
• Medication Clinical Decision Support (mCDS) Scenarios Build
• Venue of Care Filtering PowerPoint
• mCDS – Making Clinical Alerts Meaningful
124. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
12
3
TPN
• Filters within the TPN when TPNs are built as an IV set
• Alert before the filter is applied
125. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
12
4
• Filtering duplication checking within a TPN
• All About Medication Clinical Decision Support
• Dashboard Reference Pages PharmNet Inpatient
Reference Pages All About Medication Clinical Decision
Support
• https://wiki.ucern.com/display/public/reference/All+About+Med
ication+Clinical+Decision+Support
• Go under the additional information hyperlink
• Medication Clinical Decision Support (mCDS) Scenarios Build
• Venue of Care Filtering PowerPoint
• mCDS – Making Clinical Alerts Meaningful
TPN
127. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
12
6
Order Detail Filtering
• Create meaningful alerts that enhance safety
and improve patient care by making alert more
patient specific.
128. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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12
7
Order Detail Filtering
• Examples
• Filter out specific alerts for providers
• Cardiologic vs. Infection Control Physician
• Filter out alerts for due to specific routes
• Anticholinergents and Potassium Chloride
• Ciprofloxacin and Antacids
• Allow multiple drugs to be ordered based on PRN
reason
• Narcotic Analgesics
• Allow multiple drugs to be ordered based on
frequency
• Midazolam
• Aspirin and NSAIDs
129. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
12
8
Order Detail Filtering
• Examples
• Filter out specific alerts for providers
• Cardiologic vs. Infection Control Physician
• Filter out alerts for due to specific routes
• Anticholinergents and Potassium Chloride
• Ciprofloxacin and Antacids
• Allow multiple drugs to be ordered based on PRN
reason
• Narcotic Analgesics
• Allow multiple drugs to be ordered based on
frequency
• Midazolam
• Aspirin and NSAIDs
130. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
12
9
Order Detail Filtering
• Examples
• Filter out specific alerts for providers
• Cardiologic vs. Infection Control Physician
• Filter out alerts for due to specific routes
• Anticholinergents and Potassium Chloride
• Ciprofloxacin and Antacids
• Allow multiple drugs to be ordered based on PRN
reason
• Narcotic Analgesics
• Allow multiple drugs to be ordered based on
frequency
• Midazolam
• Aspirin and NSAIDs
131. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
13
0
Order Detail Filtering
• Examples
• Filter out specific alerts for providers
• Cardiologic vs. Infection Control Physician
• Filter out alerts for due to specific routes
• Anticholinergents and Potassium Chloride
• Ciprofloxacin and Antacids
• Allow multiple drugs to be ordered based on PRN
reason
• Narcotic Analgesics
• Allow multiple drugs to be ordered based on
frequency
• Midazolam
• Aspirin and NSAIDs
132. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
13
1
Order Detail Filtering
• Examples
• Filter out specific alerts for providers
• Cardiologic vs. Infection Control Physician
• Filter out alerts for due to specific routes
• Anticholinergents and Potassium Chloride
• Ciprofloxacin and Antacids
• Allow multiple drugs to be ordered based on PRN
reason
• Narcotic Analgesics
• Allow multiple drugs to be ordered based on
frequency
• Midazolam
• Aspirin and NSAIDs
133. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
13
2
Order Detail Filtering
• Filtering alerts based on orderable or drug
category and order entry format fields
• Strength dose
• Volume dose
• Duration
• Route
• Dosage form
• Frequency
• PRN reason
134. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
13
3
Order Detail Filtering
• Build in Bedrock
• Filtering of orderable and order details
• When a second order is placed with the same data an alert
will fire
• Based on orderable or drug category
• Based on order entry details
• Can be based on provider’s position
• At least one orderable/drug category and one
order entry detail are required
• Up to four different scenarios
• Next package will have 10 filters
135. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
13
4
Order Detail Filtering
• Bedrock.exe Quality Reporting and MPages MPage Setup
Medication Clinical Decision Support (mCDS) Order Detail
Filtering Group
136. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
13
5
Order Detail Filtering
• Examples
• Potassium Chloride and Anticholinergic Medications
• Narcotics with Different PRN Reasons
• Amlodipine and Strength of Simvastatin
• Position Filtering
• All About Medication Clinical Decision Support
• Dashboard Reference Pages PharmNet Inpatient
Reference Pages All About Medication Clinical Decision
Support
• https://wiki.ucern.com/display/public/reference/All+About+Med
ication+Clinical+Decision+Support
• Go under the additional information hyperlink
• Medication Clinical Decision Support (mCDS) Scenarios Build
• Venue of Care Filtering PowerPoint
• mCDS – Making Clinical Alerts Meaningful
138. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
13
7
mCDS Set Up
• Set preferences
• Run Bedrock Wizard for Multum content
• Up to date Multum content
• Attach missing CKI’s
• Use meds_cki_utility to remove incorrect CKI’s
139. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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13
8
mCDS Set Up
• Develop the scenario
• Criteria for filtering
• Primary level
• Drug drug interactions
• Drug allergies
• Drug duplication
• Criteria on patient’s profile
• Lab values
• Age
• Order Detail Specific
• PRN reason
• Route
• Doseform
140. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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13
9
mCDS Set Up
• For better maintenance customize or filter at the
highest level
• Preference
• Multumcustom.exe
• Drug drug interactions at primary level
• Duplicate Therapy suppression and repeat numbers
• Allergies at primary level
• Discern Alerts
• Lab Values
• Age
• Order Detail Filtering
• PRN reason
• Route
• Doseform
141. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
14
0
Trouble Shooting
• Order Detail Filtering
• Run scenario without filter and get an alert
• This will let you know if there is something else not set
correctly
• CKI
• Preference
• Other Customizations
• Set up filter
• If multiple order details try setting one test and then set
the second one
• Run scenario not to receive an alert
• Run scenario to receive an alert
142. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
14
1
Trouble Shooting
• When receiving an alert and not expecting an
alert
• Use the duplicate therapy text to find out if it is an
individual drug or class duplicate
143. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
14
2
Trouble Shooting
• Use Check Interactions before signing the
order.
144. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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14
3
Trouble Shooting
• Use Alert History when still verifying or
ordering.
145. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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14
4
Trouble Shooting
• Use Alert History after the order has been
signed.
146. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
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14
5
Trouble Shooting
• Use Alert History after the order has been
submitted.
147. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
14
6
mCDS Set UP
• All About Medication Clinical Decision Support
• Dashboard Reference Pages PharmNet
Inpatient Reference Pages All About Medication
Clinical Decision Support
• https://wiki.ucern.com/display/public/reference/All+
About+Medication+Clinical+Decision+Support
• Go under the additional information hyperlink
• Medication Clinical Decision Support (mCDS) Scenarios
Build
• Venue of Care Filtering PowerPoint
• mCDS – Making Clinical Alerts Meaningful
149. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
14
8
Alert Maintenance
• The ability to turn on alerts for only certain
drug orderables or drug categories.
• Allergies
• Drug Duplicates
• Set up in Bedrock
150. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
14
9
Alert Maintenance
• Alert Maintenance
• All About Medication Clinical Decision Support
• Dashboard Reference Pages PharmNet Inpatient
Reference Pages All About Medication Clinical
Decision Support
• https://wiki.ucern.com/display/public/reference/All+About
+Medication+Clinical+Decision+Support
• Go under the additional information hyperlink
• Medication Clinical Decision Support (mCDS) Scenarios Build
• Venue of Care Filtering PowerPoint
• mCDS – Making Clinical Alerts Meaningful
152. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
15
1
Documentation for mCDS
• All About Medication Clinical Decision Support
• Dashboard Reference Pages PharmNet Inpatient
Reference Pages All About Medication Clinical Decision
Support
• https://wiki.ucern.com/display/public/reference/All+About+Med
ication+Clinical+Decision+Support
• Go under the additional information hyperlink
• Medication Clinical Decision Support (mCDS) Scenarios Build
• Venue of Care Filtering PowerPoint
• mCDS – Making Clinical Alerts Meaningful
• uCern Medication Clinical Decision Support (mCDS)
• https://connect.ucern.com/groups/medication-clinical-decision-
support-mcds
153. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
15
2
Documentation for mCDS
• All About Medication Clinical Decision Support
• Dashboard Reference Pages PharmNet Inpatient
Reference Pages All About Medication Clinical Decision
Support
• https://wiki.ucern.com/display/public/reference/All+About+Med
ication+Clinical+Decision+Support
• Go under the additional information hyperlink
• Medication Clinical Decision Support (mCDS) Scenarios Build
• Venue of Care Filtering PowerPoint
• mCDS – Making Clinical Alerts Meaningful
• uCern Medication Clinical Decision Support (mCDS)
• https://connect.ucern.com/groups/medication-clinical-decision-
support-mcds
Editor's Notes Drop around OCT-11 from implementing mCDS, primarily from filtering allergies (i.e. constipation vs anaphylaxis)
Jan-12 drop is from implementing duplicate therapy with repeat numbers
Slight drop in around February 12 is from localizing repeat numbers