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No More NUPOR – Near Universal Pharmacist Order Review


The concept of studing the possibility to eliminate NUPOR with better computerized clinical decision support originated with Allen Flynn, pharmacist informatics guru at Univ of Michigan Medical Center.  He will have a brilliant commentary in the Am Journal of Health System Pharmacy in the April 1, 2009 issue.  I will have a follow up in the April 15th issue and Dennis Tribble, CTO/CPO, ForHealth Technologies will have a subsequent letter on the subject in the May or June time frame.

The basic premise is that we need to study the impact of mandating near universal pharmacist order review on patient care and the profession.  If computerized clinical decision support can do some part or segment of order review as good or better than pharmacists, then that will free pharmacists to do more beneficial services for patients.  The AJHP commentaries will explore this in some depth.   I encourage all to read and comment on this revolutionary topic.  Please comment directly in the new AJHP response system on the site that is below the articles.  Of course I welcome comments to this blog, but that will have wider exposure (for now, at least).

At a speech by Robert Wachter of the great blog Wacher’s World he indicated that when you gore sacred cows, expect a lot of Mooing.  NUPOR is a pharmacy sacred cow.  From time to time I will be posting the various Mooing and Musings on this topic.  I welcome your comments as this plays out, which I suspect might be a number of years.

John Poikonen, PharmD

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