title: Enhancing an ePrescribing system by adding medication histories and formularies: the Regenstrief Medication Hub.
abstract: Medication histories improve health care quality and safety; formularies serve to control costs. We describe the implementation of the Regenstrief Medication Hub: a system to provide both histories and formularies to the Gopher ePrescribing application. Currently the Medication Hub aggregates data from two sources: the RxHub consortium of pharmacy benefit managers, and Wishard Health Services. During one month, the system generated 53,764 queries, each representing a patient visit. RxHub responded with 4,012 histories; Wishard responded with 23,421 histories. The Medication Hub aggregated and filtered these histories before delivering them to Gopher. However, clinician users accessed the histories during only 0.6% of prescribing sessions. The Medication Hub also managed drug benefit eligibility data, which enabled formulary-based decision support. However, clinicians heeded only 41% of warnings based on the Wishard Formulary, and 16% of warnings based on commercial formularies. The Medication Hub is scalable to accommodate additional pharmacy data sources.
authors.affiliation: Regenstrief Institute, Inc, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Linas
authors.initials: L
authors.lastname: Simonaitis
authors.forename: Anne
authors.initials: A
authors.lastname: Belsito
authors.forename: J Marc
authors.initials: JM
authors.lastname: Overhage
mesh_terms: D004346:Drug Information Services / Q000458:organization & administration*; D055695:Electronic Prescribing; D005568:Forms and Records Control / Q000458:organization & administration*; D005569:Formularies as Topic; D007196:Indiana; D008487:Medical History Taking / Q000379:methods*; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D018511:Systems Integration