A growing number of hospitals and health systems are using EHR tools to autoverify some medications without a pharmacist’s review, according to the American Society of Health-System Pharmacists.
No industrywide guideline for this practice currently exists, so an ASHP working group investigated autoverification in health systems to craft an implementation framework. They published their findings July 25 in the American Journal of Health-System Pharmacy.
Typically, pharmacists review all prescriptions in EHRs and, if they deem the medication as safe and appropriate, will verify the order before its administration. Pharmacists can clarify and revise the prescription if needed.
Accreditation organizations and state boards of pharmacy often allow exceptions for emergency situations; medications can be ordered and dispensed by clinicians in some cases and areas, including operating rooms and emergency departments.
The use of autoverification has grown in recent years, according to the ASHP. In 2016, 51.6% of hospitals reported using an EHR autoverification tool. By 2023, that figure rose to 73.4%.
With nearly 3 in 4 hospitals verifying prescriptions in EHRs without a pharmacist’s review, the ASHP working group said it discovered a “catch-22.”
“Those wishing to scale use of autoverification are somewhat in a ‘catch-22’ where there is not yet enough experience to inform practice standards and regulatory and accreditation acceptance, but the evidence base cannot be built without implementation,” the report said.
Autoverification can give more time to pharmacists for complex and critical medication orders, and it can yield more equitable care and timely medication delivery, the report said. However, healthcare organizations need to construct safeguards while best practices are being defined.
Rochester, Minn.-based Mayo Clinic and Charlotte, N.C.-based Advocate Health presented case studies to the ASHP working group. The group also heard from CMS, the Joint Commission and the Institute for Safe Medication Practices.
The ASHP working group recommended hospitals meet with state boards of pharmacy to create autoverification safeguards. Those protections include ensuring reliable patient information is gathered, such as contraindications, and developing standards for high-risk medications, such as opioids.
