E-prescribing

A variety of error rates for different aspects of the medication use process have been reported. Researchers use different methodologies and definitions of medication error, and study different aspects of the medication use process (i.e., prescribing, dispensing, administering). Because there is no national standardization for the denominator used to report medication error rates, the denominator can vary among several, including doses dispensed, doses administered, doses ordered, and patient days. Therefore, the rates reported in the literature are limited in their use for comparative purposes [5]. 

The information technology demands of Part D remain unclear as they relate to electronic prescribing and its impact on pharmacy. Currently, pharmacies interact with PDPs electronically to determine eligibility and adjudicate claims. The MMA directed the Secretary of Health and Human Services to establish federal standards for e-prescribing. Five pilot studies conducted in 2005-2006 tested six standards, showing that three standards are ready for implementation. Standards related to prior authorization, structured... 

SIG (prescription instructions), and RxNorm (standard name, dose, and form availability) were not considered ready for implementation because of numerous approaches used in these three areas across health information technology. Electronic prescribing is not required under MMA, but plans are to have it available should providers choose to use it. As standards are developed, the adoption of e-prescribing is expected to improve patient safety by reducing prescribing and dispensing errors (Agency for Healthcare Research Quality, 2007). 

A local physician has approached you about the possibility of establishing a paperless e-prescribing system with your pharmacy. What are the risks involved, and how can you minimize those risks ... 

Acts of commission (i.e., prescribing, dispensing, and medication administration errors)... 

Fraizer C. E-prescribing in clinical practice. J Med Pract Manage 2004 20 148-151. 

It should be noted that off-label use of approved products (i.e. prescribing lawfully marketed products for indications other than those stated in their labeling) does not require an Emergency IND, under 21 CFR paras 312.2(b)(i)-(v), provided that the intended use... 

Three general conditions are noteworthy here Because E prescribes the invariance associated with continuous changes from any point of the function space of field solutions, to any other that is arbitrarily close, E must be locally compact. 

Hollingworth, W., Devine, B.B., Hansen, R.N. etal (2007) The impact of e-prescribing on prescriber and staff time in ambulatory care clinics a time motion study. Journal of the American Medical Informatics Association, 14(6), 722-730. 

If a substance that is prescribed in international imits (lU) needs to be weighed, the amount of substance is calculated with the conversion factor that is listed on the label or in the analytical report. For vitamins A and D the number of international units per gram is standardised. Other well-known examples are polymyxin and vitamin E. Prescribers often continue writing in units, even when, for the relevant active substance, a known chemical content has existed for a long time. 

Product specifications for microbial food enzymes have been estabUshed by JECEA and ECC. They limit or prescribe the absence of certain ubiquitous contaminants such as arsenic, heavy metals, lead, coliforms, E. coli and Salmonella. Furthermore, they prescribe the absence of antibacterial activity and, for fungal enzymes only, mycotoxins. 

These differential equations are readily solved, as shown by Luyben (op. cit.), by simple Euler numerical integration, starling from an initial steady state, as determined, e.g., by the McCabe-Thiele method, followed by some prescribed disturbance such as a step change in feed composition. Typical results for the initial steady-state conditions, fixed conditions, controller and hydraulic parameters, and disturbance given in Table 13-32 are listed in Table 13-33. 

Methods which ai e described in Phamiacopoeias (American, British, and European) ai e based on using narrow standai ds for calibration and broad standai d for system suitability test. Prescribed limits of system suitability ar e broad and therefore it may cause large uncertainty of results. But on the other side results ar e strongly influenced by par ameters of chromatographic system. 

For shaft heights 56 mm and above, ISO 2373 (lEC 60034-14) has prescribed three categories of vibration levels in terms of vibration velocity, one for normal use, N, and the other two for precision applications, i.e. reduced level R and special-purpose S. When required other than normal, these must be specified by the user to the manufacturer. Machines with a higher degree of balance should be used only when this is essential. Such machines may be far too expensive to produce, and sometimes not commensurate with the application. 

The sulfone is not completely dissolved at this point. The prescribed ratio of sulfone to carbon tetrachloride (0.0467 g ml) is important, tf it is less (i.e., more carbon tetrachloride relative to sulfone), considerable 3,3-dichlorothietane 1,1-dioxide will be formed. 

In a normal molecular dynamics simulation with repeating boundary conditions (i.e., periodic boundary condition), the volume is held fixed, whereas at constant pressure the volume of the system must fluemate. In some simulation cases, such as simulations dealing with membranes, it is more advantageous to use the constant-pressure MD than the regular MD. Various schemes for prescribing the pressure of a molecular dynamics simulation have also been proposed and applied [23,24,28,29]. In all of these approaches it is inevitable that the system box must change its volume. 

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