May 9, 2008

RxStar application hits useage milestone

Featured Image

Laura Butler, N.P., left, recently wrote the 1 millionth RxStar prescription. Here, she receives a commemorative gift from Anna Rezunenko, one of the developers of the prescription-writer application, at a recent celebration. (photo by Neil Brake)

RxStar application hits useage milestone

Late last month, Laura Butler, N.P., a kidney and pancreas transplant coordinator, wrote the 1 millionth RxStar prescription.

The team that created and continues to develop the Vanderbilt network prescription-writer application had been keeping a close eye on the tally, waiting for it to hit that seventh digit.

Butler was a special guest at a celebration of the milestone this week.

“We rely on RxStar in our area,” she said. “The benefits are pretty clear, from legibility for the pharmacist to ease of medical records management and communication across the patient care team,” she said.

Another high-volume user, Adult Primary Care's Rachel Jackson, L.P.N., highlighted the time saved by RxStar. “We have a high-volume clinic, so we have a need for speed, and RxStar definitely gives us that,” she said.

William Serafin, M.D., an RxStar prescriber, questions whether Vanderbilt providers who've yet to take up RxStar — everyone's been introduced to the application but not all currently use it — realize its value in updating a patient's electronic medical record. “I use RxStar because it's faster and more legible, but also because it automatically updates the medication list,” Serafin said.

Since its launch in early 2004, RxStar has acquired more than 1,000 users from every corner of Vanderbilt Medical Group. They generate approximately 60,000 electronic prescriptions per month, which amounts to somewhere between 30 percent and 50 percent of all VMG prescriptions.

Safety is RxStar's true calling card. The application alerts the user when a dosage appears to be out of range or when a prescription appears to be contraindicated by a known drug allergy. It updates the summary section of the electronic medical record and the patient's overall medications log.

Developers for RxStar are Vikas Jain and Anna Rezunenko. The project is directed by Kevin Johnson, M.D., and managed by Wendy Kiepek, R.N. Kristina Statnikova is an analyst for the project. Beth Dunaway leads testing of RxStar and other Informatics Center applications. Other contributors include Dario Giuse, Ed Shultz, Roger Adamson, Jim Weaver, Fern FitzHenry, Ted Slusser and Jeff Byrd.

On Monday the team held a celebration, inviting Butler as well as the five highest-volume RxStar prescribers and the five highest-volume nurse users.

Most users cite RxStar's contribution to clinic efficiency. Loath to spend the day on the phone with pharmacists, nurses appreciate the ability of faxing prescriptions directly from the application to pharmacies in five states. RxStar knows which insurance plans cover which medications, alerts the user when a drug isn't covered, and suggests substitute medications that are covered.

An evaluation of the effects of RxStar on patient safety has begun. Already, the team has learned its use is associated with a lower rate of errors caught by pharmacists, and that the application can serve to improve significantly the probability of a prescription being written using a less expensive generic formulation.

RxStar will soon be upgraded with state-of-the-art technology to decrease drug interaction errors and to transmit prescriptions to the patient's pharmacy. Plans are also under way to introduce users of Vanderbilt's hospital order entry system to RxStar for writing discharge prescriptions.

According to Johnson, only around 15 percent of prescribers nationwide currently use electronic prescription writers.