title: Electronic medical record reduces HIV medication refill response time and emergency refills in a Latino community clinic.
abstract: In May 2006, our community clinic, serving mainly indigent HIV+ Latinos, initiated an electronic medical record (EMR) system that transmitted refill requests and responses between the pharmacy's software to and from the EMR. Prior to this time, refill requests had been perceived as delayed at times due to system problems and pharmacies had responded by issuing emergency refills of antiretrovirals to prevent possible medication resistance and morbidity as may result from missed doses. The EMR service appeared to reduce response time and errors. HealthMatics EMR and the Internet service SureScripts, in cooperation with two MOMS pharmacies, were utilized. We compared the following data from before EMR initiation and after 10 months of use: number of emergency refills/28 days, response times of the clinic to refill requests and opinions of the pharmacists. The average refill response time decreased from 1.57 to 1.04 days (P < 0.004) from 2006 (n = 115) to 2007 (n = 217). Variance decreased from 3.53 to 1.73, respectively, between two same 28-day periods. Before EMR, one pharmacy felt the response times were worse than other clinics, but both perceived general improvement with EMR. The numbers of emergency refills per period were 88 and <1 respectively. In conclusion, with the utilization of EMR for medication refill requests, (1) there was a statistically significant decrease in emergency refill utilization, (2) there was a statistically significant improvement in the response time to a refill request, and (3) pharmacists perceived improvement in response times.
authors.affiliation: Western University of Health Sciences, College of Osteopathic Medicine of the Pacific, Pomona, CA 91766-1854, USA. dpearce@westernu.edu
authors.forename: D D
authors.initials: DD
authors.lastname: Pearce
authors.forename: J M
authors.initials: JM
authors.lastname: Opperman
mesh_terms: D000554:Ambulatory Care Facilities / Q000639:trends*; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D003157:Community Pharmacy Services / Q000639:trends*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D057286:Electronic Health Records; D015658:HIV Infections / Q000188:drug therapy*; D006630:Hispanic or Latino; D006801:Humans; D012189:Retrospective Studies
chemical_list: D044966:Anti-Retroviral Agents