Smart

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The greater use of digital systems and automated drug cabinets will improve the audit trail, provide controlled access, and create consistency in processes. Automated dispensing systems can enhance the efficiency of CD workflow and dispensing between wards and pharmacy.

Participants frequently mentioned using SMART messages as prompts for discussing patient safety when interacting with trainees, colleagues, or referring physicians. Trainees could follow evidence links with modified Beers’ Criteria to review the advantages and disadvantages associated with continuing or discontinuing a particular medication. Some respondents mentioned referencing the alerts during patient education, discouraging specific problem medications (eg, hypnotics), emphasizing the importance of medication compliance, or simply printing linked information for patients to take home. Respondents frequently suggested that the SMART CDS should have the greatest clinical impact for physicians less acquainted with complex care of older adults:Fewer patients with both paper and electronic prescriptions, making it easier for them as all their prescriptions can be sent electronically to their nominated pharmacy;

Bankrate has partnerships with issuers including, but not limited to, American Express, Bank of America, Capital One, Chase, Citi and Discover. Several studies have described how CDS Hooks can be integrated into an EHR to provide clinical care recommendations. 9–13 In the majority of these studies, the CDS Hooks deployments were limited to development platforms. 9–11 Two studies described the use of CDS Hooks-based CDS systems in production environments. Semenov et al 12 described a CDS platform implemented in a production environment, but they did not evaluate the efficacy of the system. Rubin et al deployed a CDS Hooks-based CDS system in a production environment to recommend HIV screening in patients where the HIV status was unknown. They performed a before-and-after study and found an action was taken by providers on 1% of the CDS Hooks reminders. 13Audit of the CD record keeping is important, but of a variable nature, and may involve daily or weekly review, and utilise independent pharmacy assessment on a quarterly or 6 monthly – basis. CDtransport Signature – The prescription needs to be signed by the prescriber with their usual signature. Advanced electronic signatures can be accepted for Schedule 2 and 3 CDs where the Electronic Prescribing Service (EPS) is used. The guidance governing the handling of CDs in hospitals requires updating to bring it into line with technology available. The Royal Pharmaceutical Society’s Medicines, Ethics and Practice Guide needs to reflect the current and developing practice in the hospital setting. The legal framework requiring a wet signature on prescription stationery for CDs to be taken out of the hospital by a