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CCHIT Crazy Criteria

07/25/2010

In discussing the CCHIT criteria with a vendor friend of mind some real “head scratchers” came up.  These examples point out the problem with certification or perhaps the lack of clinical skills at CCHIT.

 

The first was Inpatient script # 1.47  “in order entry, “Search for drug by therapeutic class catecholamines.”

  • First who orders by therapeutic class? Dah.  Second who would search for catecholamines?  Double Dah.  Thirdly, catecholomines is a chemical class not a therapeutic class.
  • How about searching for an antibiotic class that have sensitivity to the patient’s infection, is on the formulary and is recommended for antibiotic rotation?  Opps that is way too hard for most EMRs. 

 Second, Inpatient script # 1.39 “System identifies that multiple medications from the same therapeutic class (ibuprofen and acetaminophen) have been ordered and informs the user”

  • While it is true that both acetaminophen and ibuprofen are both analgesics, it is a bad choice to be alerted and would contribute to alert fatigue.  It is not uncommon that these are given together for pain relief and presents no likely danger to a patient.  It is even good therapy to decrease the total dose of ibuprofen for kidney exposure and acetaminophen for liver toxicity in patients that are getting pain relief from these, instead of narcotics. 
  • How about taking into account some patient parameters before alerting to duplicate therapy?  Opps, some EMRs do this but not many.
  • Therapeutic duplications alerts are some of the more ‘dumb’ alerts produced by the drug knowledge base vendors and contribute to alert fatigue.

 

So now the vendor has to dumb down the drug knowledge base and system to pass these ridiculous scenarios.  While I over shoot the bar on my suggestions, there are many better examples CCHIT could use rather than these bizarre ones.

 

How does one get these things changed?

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