EHR Electronic Prescribing & Medication Management 2 — Questions and Answers
Question 1: What distinguishes a 'hard stop' alert from a 'soft stop' alert in a CPOE medication ordering workflow?
- Hard stops are sent to pharmacy; soft stops are displayed to prescribers only
- Hard stops prevent order completion without required action; soft stops can be overridden with acknowledgment (Correct answer)
- Hard stops cancel the order automatically; soft stops delay processing by 30 minutes
- Hard stops require supervisor approval; soft stops require patient consent
Correct answer: Hard stops prevent order completion without required action; soft stops can be overridden with acknowledgment
A hard stop alert prevents the clinician from proceeding with an order until a required action is taken, whereas a soft stop warns the clinician but allows the order to continue after acknowledgment.
Question 2: What is 'tall man lettering' and how is it used in EHR medication displays?
- Larger font size for high-alert medications on the MAR
- Mixed-case formatting to visually distinguish look-alike/sound-alike drug names (Correct answer)
- Bold formatting for medications requiring a co-signature
- All-caps display for generic versus brand name medications
Correct answer: Mixed-case formatting to visually distinguish look-alike/sound-alike drug names
Tall man lettering uses mixed-case formatting (e.g., DOPamine vs DOBUTamine) to help clinicians visually differentiate look-alike/sound-alike drug names and reduce selection errors.
Question 3: Which organization maintains the National Drug Code (NDC) directory used in EHR medication databases?
- The Joint Commission (TJC)
- Food and Drug Administration (FDA) (Correct answer)
- Centers for Medicare & Medicaid Services (CMS)
- National Council for Prescription Drug Programs (NCPDP)
Correct answer: Food and Drug Administration (FDA)
The FDA maintains the NDC directory, which serves as the universal product identifier for human drugs and is widely used in EHR medication databases for product identification.
Question 4: A 'Best Possible Medication History' (BPMH) is most accurately obtained by:
- Downloading data from the patient's insurance claims database
- Interviewing the patient and cross-referencing multiple medication sources (Correct answer)
- Pulling the previous provider's discharge summary only
- Using the pharmacy's dispensing records as the sole source
Correct answer: Interviewing the patient and cross-referencing multiple medication sources
A BPMH is created by conducting a patient interview and reconciling information from multiple sources (pharmacy records, pill bottles, caregiver input) to produce the most complete and accurate medication history.
Question 5: Which EHR feature uses pre-populated, standardized medication orders to reduce prescribing variability and errors?
- Medication reconciliation workflow
- Order sets with evidence-based protocols (Correct answer)
- Drug utilization review reports
- Prior authorization queues
Correct answer: Order sets with evidence-based protocols
Order sets provide pre-populated, evidence-based medication orders with standard doses and instructions, reducing variability and supporting clinical best practices at the point of ordering.
Question 6: What primary function does the Surescripts network serve in electronic prescribing?
- Drug-drug interaction checking between systems
- Routing electronic prescriptions and providing real-time pharmacy benefit information (Correct answer)
- Formulary management for hospital inpatient pharmacies
- Tracking medication administration in acute care settings
Correct answer: Routing electronic prescriptions and providing real-time pharmacy benefit information
Surescripts operates the national health information network that routes electronic prescriptions from EHR systems to pharmacies and provides real-time pharmacy benefit and eligibility data to prescribers.
Question 7: RxNorm is important in EHR medication management primarily because it:
- Sets the maximum daily dose guidelines for all US medications
- Provides standardized drug names and identifiers enabling consistent data exchange (Correct answer)
- Functions as the billing code set for prescription drugs under Medicare
- Tracks FDA approval status for all new drug applications
Correct answer: Provides standardized drug names and identifiers enabling consistent data exchange
RxNorm provides standardized clinical drug names and identifiers maintained by the NLM, enabling EHR systems, pharmacies, and other health IT applications to exchange medication information consistently.
EHR Electronic Prescribing & Medication Management 2
What distinguishes a 'hard stop' alert from a 'soft stop' alert in a CPOE medication ordering workflow?