.....prescription process can incur high costs in the healthcare industry due to poor risk management. Lack of continued assessment, technological upgrades, and information sessions can lead to an increased rate of data entry errors. Data entry errors may result in patient deaths, and lawsuits that lessen the financial success of any hospital/clinic. However, there is opportunity to reduce data entry errors in order to minimize negative outcomes related to prescription errors and patient satisfaction. The recommendation for minimizing negative outcomes is to incorporate a cloud service that allows for integration of existing electronic prescription records, allowing optimization of prescriptions from doctor/nurse to pharmacy to patient, thus minimizing potential data entry error. The impact the cloud service application can have on healthcare can be great. Costs may be reduced and legal ramifications from human error can be avoided by exemplifying the risk management essentials of assessment, technological upgrades, and training. Part I

Introduction:

Risk management for the prescription process entails analysis of problems existing in the pharmacy in relation to wait times, communication between different parties, and customer satisfaction. Regarding wait times, the average wait time for prescriptions can take approximately half an hour. Examining this information from the perspective of risk management, the wait time affects the satisfaction level of patients looking to receive their medications. If the patients wait longer than expected, they may take their business elsewhere, minimizing profit potentials for a pharmacy.

Another key aspect of risk management is identification of stake holders. The stake holders within this scenario are patients, doctors, nurses and pharmacies. If doctors and/or nurses prescribe medications and the patient must wait a long time to receive it because of the pharmacy, there may be less motivation on the part of the patient to follow through with acquiring medications. This can lead to lower satisfaction with care and/or a lower quality of delivery of care.

When understanding the risk a certain action produces (data entry error), one cannot ignore the legal ramifications of said actions in the prescription process. Potential legal ramifications associated with the prescription process include legal battles and expenses associated with court cases, wasteful healthcare spending, and lethal prescription errors. Such legal ramifications could worsen thanks to recent healthcare policy changes.

Examining the problem through STEEPLE Factors, new healthcare changes can lead to increased rates of data entry error. For example, the Affordable Care Act requires any U.S. citizen to have health insurance or else subject to monetary penalties (Rawal, 2016). This means more U.S. citizens will have access to healthcare than ever before. To meet the demands, hospitals and clinics must update their systems to provide effective and fast service. This can come in the form of expansion of the hospital or clinic by incorporating a pharmacy or updating older information technology systems.

The Lerdsin Hospital had problems with prescription error because of the structural constraints of its small pharmacy. When it was enlarged, and updated with new equipment, it was able to meet the demands of the increased number of patients. To acquire the information needed to make such changes, the assessment of the situation came in the form of staff interviews as well as performing numerous observational studies within and around the pharmacy.

They assessed pharmacy layout, prescription timing, and finally, patient and staff traffic flow. They determined the cashier step took the longest within the prescription process. From there, they realized the ineffective layout of the pharmacy, and the overall prescription volume. They recommended a restricting of the existing layout for the low-end budget and for the high-end, an overhaul of equipment, focusing... By accommodating for the patients and placing prescription drugs in a convenient, easy to access location, they made more effective the use that was already there.
This is how risk management for the prescription process can lead to positive outcomes. By assessing and analyzing data collected, it can lead to a better understanding of the problem and thus, prompt resolution. Assessment involves detailing the input and output process. As mentioned previously, doctors and nurses write out prescriptions for patients. This represents one part of the input aspect. If this were a diagram, the second part of the input aspect involves having the patient give his or her prescription(s), to the pharmacy. When looking at the output aspect, the pharmacy gives the medications to the patient, ending the process. This is a basic representation of the project scope diagram.

A high-level process diagram of inputs and outputs is performed in the order of patient, doctor/nurse, and pharmacy. Meaning, a patient must undergo the process of asking if a prescription is required. This involves a diagnosis performed by the doctor (or nurse depending on the area), and then data entry into an electronic prescribing system. Should anything need to be authorized by health insurance or by the doctor in terms of changes of prescription, this process will continue. The pharmacy receives the prescription and checks for prescription authorization. Once the pharmacy is notified of the authorization, the pharmacy checks it the prescription is dispensable. If it can be, it is dispensed, leading the patient to receive his or her medication.

Without this clear description of the prescription process, there is little that can be done to minimize associated risks. For example, since the data must be put in, electronically, data entry becomes a focal point to the risk management process. Further exploration of the process narrative can yield even better results.

2. Refinement of Process

A more complex narrative of the scope diagram means including healthcare policy, prescription drugs regulations, and technology. For example, the FDA and HIPAA regulate prescription drugs (FDA) and set the standards for security of health information systems (HIPAA). Legal services check the terms and guidelines of contracts. This represents the GUIDES side of the INPUTS and OUTPUTS prescription process.

The INPUTS side has cloud service costs, prescription and patient data, and updated software/maintenance costs. This is what goes into sending a prescription, receiving a prescription, and performing the necessary tasks to get the prescription to the patient. The OUTPUTS involve a cloud service license, support and maintenance, and generated prescriptions requests. The next part involves ENABLERS and these are doctors and nurses, the billing department, pharmacists, Information Technology (IT), and healthcare. These are areas the patient, doctors/nurses, and pharmacists must communicate and interact in, to achieve the result of getting the patient his or her prescribed medication. By further detailing the prescription process, the result is a clear image of where the most problems arise, equipment/software purchase, service, and maintenance.

3. Problems/Opportunities

The prescription process can have problems in several key areas. The main area however, is technology. As identified, the current state of software and service/maintenance of software is integral regarding data entry error. When this area lacks proper assessment, it can lead to problems in service for the pharmacy, the doctors/nurses, and then ultimately the patient. An opportunity to check for existing Medical Electronic Systems and their susceptibility for integration to a different process may lead to a solution that is lower cost than generating a new system and can be implemented via information sessions for employees. The solution is a prescription cloud service.…