System and software of enhanced pharmacy services and related methods

• US 20060149416A1
• Filed: 07/01/2005
• Published: 07/06/2006
• Est. Priority Date: 12/03/2004
• Status: Active Grant

• Current Assignee: Johns Hopkins Aramco Healthcare Company (Government of Saudi Arabia)
• Original Assignee: Saudi Arabian Oil Company (Government of Saudi Arabia)
• Inventors: Arimilli, Rao, Mohapatra, Om, Farooki, Masood U.
• Granted Patent: US 7,706,915 B2
• Time in Patent Office: Days
• US Class Current: 700/242
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

A system, software, and methods related to enhanced pharmaceutical order entry and administration by medical personnel, and enhanced pharmaceutical inventory control within a medical institution are provided. An embodiment of the system includes a pharmaceutical information management server having memory and a medication administration program product including a set of instructions stored in the memory of the pharmaceutical information management server to enhance provision of pharmacy services. The system also includes medical institution physician computers to provide for computerized physician medication order entry, pharmacy computers to provide for review and verification by a pharmacist of electronic medication orders placed through the physician computers, and medical institution nursing unit computers, to provide for review of and input to electronic medication administration records.

Claims

1. A system of enhanced pharmaceutical order entry and administration by medical personnel and enhanced pharmaceutical inventory control within a hospital, the system comprising:

a hospital information processing and management computer including memory to store data therein to thereby define a hospital information management server;

a database associated with the hospital information management server and including a plurality of patient medication profile records and a corresponding plurality of electronic medication administration records for each of a respective plurality of patients, and including a hospital drug formulary and a plurality of medication inventory records;

hospital information management software stored in the memory of the hospital information management server and including a medication administration program product comprising a set of instructions and adapted to accept remote input from a physician to access the plurality of patient medication profile records to thereby allow display of a selected patient medication profile, to access the hospital drug formulary to thereby allow selection of a desired medication, to produce and allow display of a medication order entry form having database record input fields that when accessed through instructions by the medication administration program product provide medication administration data to form an electronic medication order accessible by a pharmacist to perform a medication order verification, to provide the medication administration data to the electronic medication administration records, to interface the electronic medication administration records with the medication inventory records, and to interface the electronic medication administration records with hospital nursing member medication scheduling, to thereby provide enhanced management of medication administration in the hospital;

a communications network in communication with the hospital information management server;

a plurality of hospital physician computers positioned remote from the hospital information management server, each in communication with the hospital information management server through the communication network and each including memory and software stored in the memory adapted to provide access to the medication administration program product, to allow the physician to display a patient medication profile for a preselected patient, select a desired medication, and display a medication order entry form, so that the physician can create an electronic medication order to provide data to an associated medication profile record and an associated electronic medication administration record, defining computerized physician order entry;

a plurality of hospital pharmacy computers positioned remote from the hospital information management server, each in communication with the hospital information management server through the communication network and each including memory and software stored in the memory adapted to provide access to the medication administration program product to allow display of queued electronic medication orders awaiting verification by a pharmacist placed through the plurality of hospital physician computers, and to allow input from the pharmacist indicating verification of such medication orders in at least one of their respective medication profile records and their respective electronic medication administration records so that the pharmacist can document verifying the electronic medication orders; and

a plurality of hospital nursing unit computers positioned remote from the hospital information management server, each in communication with the hospital information management server through the communication network, and each including memory and software stored in the memory adapted to provide access to the medication administration program product to also allow computerized physician order entry so that a nursing unit member can input a physicians medication order, to allow display of scheduled inpatient verified medication orders so that the nursing unit member can review pharmacist and physician notes and special instructions and sign-off the scheduled medication orders, and to allow input to the electronic medication administration records so that the nursing unit member can indicate completed administration of the inpatient verified medication orders.

2. A system as defined in claim 1, wherein each of the patient medication profile records stored in the database comprise a single consolidated patient medication profile including both inpatient and outpatient prescribed medications for a respective patient.

3. A system as defined in claim 1, wherein each of the plurality of electronic medication administration records provide a single consolidated patient medication administration profile for a corresponding plurality of patients, the single profile reflecting current medication administration including both inpatient and outpatient prescribed medications.

4. A system as defined in claim 1, further comprising a plurality of automated drug dispensing devices each positioned in the hospital and in communication with the hospital information management server through the communication network to store pharmaceuticals therein and to dispense the pharmaceuticals to authorized hospital personnel located at the hospital, each automated drug dispensing device including memory and software stored in the memory to provide access to the medication administration program products to receive electronic medication administration record data and to provide an interface to modify electronic medication administration records, to thereby provide hospital personnel a tool for recording medication administered to patients.

5. A system as defined in claim 4, wherein each automated drug dispensing device maintains an accounting of inventory of medication stored therein to periodically provide the medication administration program product an inventory status usable to allow update of the medication inventory records.

6. A system as defined in claim 4, wherein each of the plurality of automated drug dispensing devices used in a nursing unit are adapted to provide automated posting of medication removal events to a patient associated electronic medication administration record.

7. A system as defined in claim 4, wherein each of the plurality of automated drug dispensing devices used in a nursing unit are positioned to perform an automated posting of a time-of-removal of medication from the respective automated drug dispensing device to a patient associated electronic medication administration record, and wherein each of the plurality of automated drug dispensing devices used in a nursing unit further comprise a user input device positioned to allow the nursing unit member to post an actual medication administration time to the patient associated electronic medication administration record when so displayed.

8. A system as defined in claim 4, wherein each of the plurality of automated drug dispensing devices used in a nursing unit provide automated creation of an electronic medication order, responsive to an authorized medication removal performed without a pre-existing medication order, and wherein each of the plurality of automated drug dispensing devices used in a nursing unit provide automated posting of the created medication order to a patient associated electronic medication administration record.

9. A system as defined in claim 1, wherein the medication administration program product is adapted to signal at least one of the hospital nursing unit computers to display an automated alert indicating a modified medication order, responsive to entry of the modified medication order.

10. A system as defined in claim 1, further comprising:

a plurality of claim card printers, each connected to a respective one of the plurality of hospital physician computers to print a claim card indicating a medication entered through computerized physician order entry; and

a plurality of nursing unit printers positioned remote from the hospital information management server, each in communication with the hospital information management server through the communication network to print a modified order responsive to completion of entry of a modified medication order.

11. A system of enhanced pharmaceutical order entry and administration by medical personnel and enhanced pharmaceutical inventory control within a medical institution, the system comprising:

a medical institution pharmaceutical information processing and management computer including memory to store data therein to thereby define a pharmaceutical information management server;

a plurality of patient medication profile records and a corresponding plurality of electronic medication administration records for each of a respective plurality of patients stored in the memory of the pharmaceutical information management server;

medication administration program product comprising a set of instructions stored in the memory of the pharmaceutical information management server that when executed by the pharmaceutical information management server accept remote input from a physician to access the plurality of patient medication profile records to thereby allow display of a selected patient medication profile, produce and allow display of a medication order entry form having input fields that when accessed through instructions by the medication administration program product provide medication administration data to form an electronic medication order accessible by a pharmacist to perform a medication order verification, provide the medication administration data to the electronic medication administration records, and provide medical institution nursing unit members automated medication administration scheduling requirements, to thereby provide enhanced management of medication administration in the medical institution;

a communications network in communication with the pharmaceutical information management server; and

a plurality of medical institution physician computers positioned remote from the pharmaceutical information management server, each in communication with the pharmaceutical information management server through the communication network and each including memory and software stored in the memory adapted to provide access to the medication administration program product to allow the physician to display a patient medication profile for a preselected patient, to select a desired medication, and to display a medication order entry form, so that the physician can create an electronic medication order to thereby provide data to an associated medication profile record and an associated electronic medication administration record.

12. A system as defined in claim 11, further comprising at least one medical institution nursing unit computer positioned remote from the pharmaceutical information management server, in communication with the pharmaceutical information management server through the communication network, and including memory and software stored in the memory adapted to provide access to the medication administration program product to also allow computerized physician order entry so that a nursing unit member can input a physician medication order, to allow display of medication orders so that the nursing unit member can review pharmacist and physician notes and special instructions and sign-off the scheduled medication orders, and to allow input to the electronic medication administration records so that the nursing unit member can indicate completed administration of the medication orders.

13. A system as defined in claim 12, further comprising at least one medical institution pharmacy computer in communication with the pharmaceutical information management server through the communication network and including memory and software stored in the memory adapted to provide access to the medication administration program product to allow display of queued electronic medication orders awaiting verification by a pharmacist placed through the at least one medical institution physician computers, and to allow input from the pharmacist indicating verification of such medication orders so that the pharmacist can document verifying the electronic medication orders.

14. A system as defined in claim 12, wherein the medication administration program product is adapted to access the plurality of patient medication profile records stored in the memory of the pharmaceutical information management server to display a single consolidated patient medication profile including both inpatient and outpatient prescribed medications for each respective patient, and to access the plurality of electronic medication administration records to display a single consolidated patient medication administration profile for a corresponding plurality of patients including both inpatient and outpatient prescribed medications.

15. A system as defined in claim 11, further comprising a plurality of automated drug dispensing devices each positioned in the medical institution and in communication with the pharmaceutical information management server through the communication network to store pharmaceuticals therein and to dispense the pharmaceuticals to authorized medical institution personnel located at the medical institution, each automated drug dispensing device including memory and software stored in the memory to provide access to the medication administration program product to receive electronic medication administration record data and to provide an interface to modify electronic medication administration records, to thereby provide nursing unit members a tool for recording medication administered to patients.

16. A system as defined in claim 15,

wherein each of the plurality of automated drug dispensing devices used in a nursing unit are positioned to perform an automated posting of a time-of-removal of medication from the respective automated drug dispensing device to a patient associated electronic medication administration record;

wherein each of the plurality of automated drug dispensing devices used in a nursing unit further comprise a user input device positioned to allow the nursing unit member to post an actual medication administration time to the patient associated electronic medication administration record when so displayed; and

wherein each of the plurality of automated drug dispensing devices used in a nursing unit are positioned to transmit data to the medication administration program product sufficient to provide for automated creation of an electronic medication order responsive to removal of medication pursuant to an unscheduled medication order.

17. A system as defined in claim 11, further comprising a medical institution nursing unit computer and video display positioned remote from the pharmaceutical information management server, in communication with the pharmaceutical information management server through the communication network, and including memory and software stored in the memory adapted to provide access to the medication administration program product, the medication administration program product adapted to signal the medical institution nursing unit computer to display on the video display an automated alert indicating a modified medication order, responsive to the modified medication order.

18. A system as defined in claim 11, further comprising a medical institution nursing unit computer and video display positioned remote from the pharmaceutical information management server, in communication with the pharmaceutical information management server through the communication network, and including memory and software stored in the memory adapted to provide access to the medication administration program product, and wherein the medication administration program product is adapted to display on the nursing unit video display an administration schedule auto-refreshed at a preselected time interval to allow automated screen shifting along a medication administration timeline to thereby provide an automated medication administration schedule.

19. A system as defined in claim 11, further comprising a medical institution nursing unit computer and a medical institution nursing unit printer each positioned remote from the pharmaceutical information management server, in communication with the pharmaceutical information management server through the communication network, and each including memory and software stored in the memory adapted to provide access to the medication administration program product, the medication administration program product adapted to signal at least one of the medical institution nursing unit computer and the medical institution nursing unit printer to cause the medical institution nursing unit printer to print a modified medication order report, responsive to the modified medication order.

20. A system as defined in claim 11, wherein the system further comprises a plurality of medication inventory records stored in the memory of the pharmaceutical information management server;

wherein the medication administration program product initiates automated inventory management transactions including issuing materials from stock and automated depletion of medication inventory from the medication inventory records, responsive to medication order entry; and

wherein the medication administration program product initiates automated replenishment of pharmaceuticals from external suppliers, responsive to the automated depletion of an individual medication below a preselected level of inventory.

21. A system of enhanced pharmaceutical order entry and administration by medical personnel and enhanced pharmaceutical inventory control within a medical institution, the system comprising:

an information processing and management computer including memory to store data therein to thereby define an information management server;

medication administration program product comprising a set of instructions stored in the memory of the information management server that when executed by the information management server cause the server to accept remote input from a physician to display a medication order entry form having input fields that when accessed through instructions by the medication administration program product provide medication administration data to form an electronic medication order, provide the medication administration data to an electronic medication administration record, and provide medical institution nursing unit members automated medication administration scheduling requirements;

a communications network in communication with the information management server; and

at least one medical institution physician computer positioned remote from the information management server and in communication with the information management server through the communication network and including memory and software stored in the memory adapted to provide access to the medication administration program product to allow a physician to display a medication order entry form, so that the physician can create an electronic medication order to thereby provide data to an associated medication profile record and an associated electronic medication administration record.

22. A system as defined in claim 21, further comprising at least one medical institution nursing unit computer positioned remote from the pharmaceutical information management server, in communication with the information management server through the communication network, and including memory and software stored in the memory adapted to provide access to the medication administration program product to allow input to an electronic medication administration record so that the nursing unit member can indicate completed administration of a medication order for a scheduled medication administration and initiate an automated creation of an electronic medication record responsive to the input of completed administration data for an unscheduled medication order.

23. A system as defined in claim 21, wherein the medication administration program product is adapted to access the patient medication profile record to display a single consolidated patient medication profile including both inpatient and outpatient prescribed medications for each respective patient.

24. A system as defined in claim 21, further comprising a plurality of automated drug dispensing devices each positioned in the medical institution and in communication with the information management server through the communication network to store pharmaceuticals therein and to dispense the pharmaceuticals to authorized medical institution personnel located at the medical institution, each automated drug dispensing device including memory and software stored in the memory to provide access to the medication administration program product to receive electronic medication administration record data and to provide an interface to modify electronic medication administration records, to thereby provide medical institution nursing unit members a tool for recording medication administered to patients.

25. A system as defined in claim 24, wherein each of the plurality of automated drug dispensing devices used in a nursing unit are positioned to transmit data to the medication administration program product sufficient to provide for automated creation of an electronic medication order, responsive to removal of medication pursuant to an unscheduled medication order.

26. A system as defined in claim 24, wherein each of the plurality of automated drug dispensing devices used in a nursing unit provide automated posting of medication removal events to a patient associated electronic medication administration record.

27. A system as defined in claim 21, further comprising a medical institution nursing unit computer and video display positioned remote from the information management server, in communication with the information management server through the communication network, and including memory and software stored in the memory adapted to provide access to the medication administration program product, and wherein the medication administration program product is adapted to signal the medical institution nursing unit computer to display on the video display an automated alert indicating a modified medication order responsive to the modified medication order.

28. A system as defined in claim 27, wherein the medical institution nursing unit video display is adapted to display a nursing-unit level electronic medication administration schedule, and wherein the automated alert includes highlighting modified medication orders on the nursing unit-level electronic medication administration schedule.

29. A system as defined in claim 21, further comprising a medical institution nursing unit computer and a medical institution nursing unit printer each positioned remote from the pharmaceutical information management server, in communication with the pharmaceutical information management server through the communication network, and each including memory and software stored in the memory adapted to provide access to the medication administration program product, and wherein the medication administration program product is adapted to signal at least one of the medical institution nursing unit computer and the medical institution nursing unit printer to cause the medical institution nursing unit printer to print a modified medication order report, responsive to the modified medication order.

30. A system as defined in claim 21,

wherein the system further comprises a plurality of medication inventory records stored in the memory of the information management server;

wherein the medication administration program product is adapted to initiates automated inventory management transactions including issuing materials from stock and automated depletion of medication inventory from the medication inventory records responsive to medication order entry; and

wherein the medication administration program product is adapted to initiates automated replenishment of pharmaceuticals from external suppliers, responsive to the automated depletion of an individual medication below a preselected level of inventory.

31. A method to enhance pharmaceutical order entry by medical personnel within a medical institution, the method comprising the steps of:

providing a graphical user interface medication order template having database entry fields displayed on a video display device to allow medication order entry by a physician at a location remote from a medical institution pharmacy, the medication order template adapted to display clinical and non-clinical alerts;

providing the physician an ability to override a clinical and non-clinical alert encountered during medication order entry and an entry field in the graphical user interface medication order template to input an override reason;

updating a patient electronic medication administration record responsive to the medication order entry by the physician;

providing a graphical user interface to display on a pharmacy clinical workstation the medication order entered by the physician, the graphical user interface displaying clinical and non-clinical alerts encountered by the physician along with overriding reasons posted with the alerts; and

reviewing and verifying the medication order displayed on the pharmacy clinical workstation.

32. A method as defined in claim 31, further comprising the step of:

performing clinical checking to verify the medication order does not exceed a normally prescribed dose range, interact negatively with other currently prescribed medications, or duplicate another currently active medication order.

33. A method as defined in claim 31, further comprising the step of:

performing non-clinical checking of the medication order to verify at least one of the following;

the medication order does not duplicate medication against a current medication profile at an ingredient level and at a therapeutic level the patient is eligible to receive items listed in the medication order, the physician is authorized to prescribe items listed in the medication order to the specific patient, and the medication order does not include items having a quantity or duration exceeding preselected institutional limits.

34. A method as defined in claim 31, wherein the step of reviewing and verifying further comprises the steps of:

providing the pharmacist a means to override a clinical and non-clinical alert encountered during medication order review and verification and an entry field to input an override reason;

allowing the pharmacist to modify the medication order and substitute a drug item upon consultation with the physician; and

processing the medication order responsive to the review and verification of the medication orders and the clinical and non-clinical checks of the medication orders.

35. A method as defined in claim 34, further comprising the steps of:

integrating pre-medication administration patient laboratory results in the medication order; and

delaying pharmacy processing of the medication order responsive to predetermined pre-medication administration patient laboratory result criteria.

36. A method as defined in claim 31, further comprising a step of:

performing intervention logging, responsive to at least one of the following overriding a clinical or non-clinical alert;

a physician a pharmacist and a medical institution nursing unit member.

37. A method to enhance pharmaceutical medication order entry by medical personnel while simultaneously reducing medication order errors, the method comprising the steps of:

providing a structured computer-based electronic medication order form including medication route, dose, frequency, and duration;

providing in the form default values for at least one of the route, dose, frequency, and duration;

providing in the form access to dosing recommendations including at least one of the following;

minimum and maximum dose, lifetime cumulative dosing, pediatric dosing, neonatal dosing, and geriatric dosing; and

providing in the form at least one of the following;

standard medication order sets, IV templates, and chemotherapy templates.

38. A method as defined in claim 37, further comprising the step of:

providing in the form a tool to select and copy a prior active or inactive medication order to function as a template for a current medication order.

39. A method as defined in claim 37, further comprising the step of:

integrating inpatient and outpatient medication orders to provide a single patient medication profile for each patient of a plurality of patients.

40. A method as defined in claim 37, further comprising the step of:

integrating patient laboratory results with the form to provide the physician data required to determine proper medication order ingredients.

41. A method to enhance pharmaceutical medication order entry by medical personnel while simultaneously reducing medication order errors, the method comprising the steps of:

providing a graphical user interface database template having database entry fields displayed on a video display device to allow electronic medication order entry by a physician at a location remote from the pharmacy;

displaying in the database template, tools to access default values for medication dosing, sets of medications frequently prescribed together, and default medication order templates, to thereby enhance medication order entry and reduce likelihood of medication order errors; and

displaying in the database template, tools to access products available to treat a preselected disease condition with emphasis on drugs in a medical institution drug formulary.

42. A method to enhance pharmaceutical medication order management compliance, the method comprising the steps of:

providing a structured computer-based electronic medication order form including access to a master list of intervention codes grouped by code type to allow capture of interventions by physicians during computerized medication order entry, pharmacists during at least one of computerized medication order entry and computerized medication order verification, and nursing unit members during at least one of computerized medication order entry and medication administration, to thereby enhance non-compliance tracking;

providing an alert during computerized physician medication order entry signaling an entry requiring an intervention event has been encountered and that an action is required to override the alert;

providing automated intervention logging to capture details of the intervention event; and

providing exception documentation for alert overrides to allow for enhanced management review.

43. A method as defined in claim 42, further comprising the step of:

providing drug restriction data containing restrictions for each medication based on physician, specialty, patient, or combination thereof including doctor-patient familial relationship restriction alerts, and patient medication abuse propensity alerts.

44. A method to enhance patient medication management by medical personnel within a medical institution, the method comprising the steps of:

providing automated stop notification to a physician responsible for a medication order scheduled to expire within the preselected time period; and

providing a physician work queue requiring the notified physician to at least one of extend the medication order or confirm the medication order stop time.

45. A method as defined in claim 44, further comprising the step of:

providing a report listing medication orders for inpatient residents at the medical institution that are about to expire within a preselected time period, the report organized by at least one of nursing unit or prescribing physician.

46. A method to enhance pharmaceutical administration, the method comprising the steps of:

displaying on a nursing unit video display device a nursing unit-level electronic medication administration screen;

monitoring the nursing unit-level electronic medication administration screen for modified medication orders; and

providing automated highlighting of modified medication orders on the nursing unit-level electronic medication administration screen.

47. A method to enhance pharmaceutical administration, the method comprising the steps of:

displaying an administration schedule on a nursing unit video display device auto-refreshed at a preselected time interval to allow automated screen shifting along a medication administration timeline; and

providing an automated alert indicating existence of a modified medication order.

48. A method as defined in claim 47, wherein the step of providing an automated alert further comprises the step of:

providing automated highlighting of modified medication orders on the displayed administration schedule;

responsive to entry of a modified medication order.

49. A method as defined in claim 47, further comprising the step of:

providing automated printing of the modified medication order on a nursing unit printer responsive to entry of the modified medication order.

50. A method to enhance pharmaceutical order entry and administration by medical personnel within a medical institution, the method comprising the steps of:

displaying on a video device positioned at a nursing unit located remote from a medical institution pharmacy a graphical user interface including electronic medication administration record data to allow medication administration entry by an authorized nursing unit member;

posting a medication administration for an emergency medical services medication order in the graphical user interface; and

performing an automated creation of an electronic emergency medical services medication order responsive to posting the medication administration for the emergency medical services medication order.

51. A method as defined in claim 50, further comprising the steps of:

providing an automated drug dispensing device located at the nursing unit;

providing permissions for emergency medical services removal of medication from the automated drug dispensing devices; and

posting a medication administration for an emergency medication order responsive to medication removal from the automated drug dispensing device.

52. A method to enhance pharmaceutical order entry and administration by medical personnel within a medical institution, the method comprising the steps of:

displaying on a video device positioned at a nursing unit located remote from a medical institution pharmacy a graphical user interface including electronic medication administration record data to allow medication administration entry by an authorized medical institution member;

posting a medication administration for an immunization medication order in the graphical user interface, responsive to immunization medication administration; and

performing an automated creation of an electronic immunization medication order including an optional physician confirmation requirement within a preselected time interval responsive to posting the medication administration for the immunization medical order.

53. A method to enhance pharmaceutical order entry by medical personnel within a medical institution, the method comprising the steps of:

integrating inpatient and outpatient medication orders stored in memory of a computer to provide a single patient medication profile for each patient of a plurality of patients; and

displaying on a physician video display device the single patient medication profile.

54. A method to enhance pharmaceutical order entry by medical personnel within a medical institution, the method comprising the steps of:

displaying on a physician video display device a graphical user interface including a medication order template having entry fields to allow electronic medication order entry by a physician;

displaying on the physician video display device at least one of a clinical and a non-clinical alert when encountered;

responsive to the electronic medication order entry by the physician; and

performing automated intervention logging, responsive to the physician overriding the alert.

55. A method to enhance pharmaceutical order entry and administration by medical personnel within a medical institution, the method comprising the steps of:

displaying on a physician video display device a graphical user interface including a medication order template having entry fields to allow electronic medication order entry by a physician;

displaying on the physician video display device at least one of a clinical and a non-clinical alert when encountered, responsive to the electronic medication order entry by the physician;

providing an entry field in the graphical user interface to post a reason for the physician overriding a displayed alert; and

displaying on a pharmacy clinical workstation video display device the medication order entered by the physician and any clinical and non-clinical alerts encountered by the physician along with overriding reasons posted by the physician with the alerts.

56. A computer readable medium that is readable by a computer to enhance pharmaceutical order entry by medical personnel within a medical institution, the computer readable medium comprising a set of instructions that, when executed by the computer, cause the computer to perform the following operations:

providing data to display on a physician video display device a graphical user interface including a medication order template having database entry fields to allow medication order entry by a physician;

populating the medication order template with default values or applying a medication order ingredient template;

providing in the medication order template access to tools for the physician to perform clinical and non-clinical checks;

providing clinical and non-clinical alerts responsive to receipt of an entry in the medication order template of a medication order parameter violating a preselected rule;

providing on the graphical user interface;

an entry field providing the physician an ability to override the clinical or non-clinical alert; and

updating a patient electronic medication administration record stored in the memory responsive to the medication order entry and the override by the physician.

57. A computer readable medium as defined in claim 56, wherein the instructions that, when executed by the computer, cause the computer to populate the medication order template with default values or apply a medication order ingredient template, further cause the computer to perform the following operations:

providing in the medication order template default values for at least one of a medication route, dose, frequency, and duration;

providing in the medication order template access to dosing recommendations including at least one of the following;

minimum and maximum dose, lifetime cumulative dosing, pediatric dosing, neonatal dosing, and geriatric dosing; and

providing in the medication order template access to at least one of the following;

standard medication order sets, IV templates, and chemotherapy templates.

58. A computer readable medium as defined in claim 56, wherein the instructions that, when executed by the computer, cause the computer to provide in the medication order template access to tools for the physician to perform clinical and non-clinical checks, farther cause the computer to perform the following operations:

performing clinical checking to verify the medication order does not exceed a normally prescribed dose range, interact negatively with other currently prescribed medications, or duplicate another currently active medication order; and

performing non-clinical checking of the medication order to verify at least one of the following;

the medication order does not duplicate medication against a current medication profile at an ingredient level or at a therapeutic level, the patient is eligible to receive items listed in the medication order, the physician is authorized to prescribe items listed in the medication order to the specific patient, and the medication order does not include items having a quantity or duration exceeding preselected institutional limits.

59. A computer readable medium that is readable by a computer to enhance pharmaceutical order entry by medical personnel within a medical institution, the computer readable medium comprising a set of instructions that, when executed by the computer, cause the computer to perform the following operations:

receiving an electronic medication order entered by a physician, responsive to medication order entry by a physician;

queuing in a pharmacist working queue the electronic medication order;

providing data to display on a pharmacy clinical workstation video display device the electronic medication order entered by the physician and clinical and non-clinical alerts encountered by the physician along with override reasons posted by the physician;

providing data to display on the pharmacy clinical workstation video display device, an entry field providing the pharmacist an ability to override the clinical or non-clinical alerts encountered during medication order review and verification and an entry field to input an override reason;

performing intervention logging responsive to the pharmacist overriding the clinical or non-clinical alert; and

processing the medication order responsive to the review and verification of the medication orders and the clinical and non-clinical checks of the medication orders.

60. A computer readable medium that is readable by a computer to enhance pharmaceutical administration by medical personnel within a medical institution, the computer readable medium comprising a set of instructions that, when executed by the computer, cause the computer to perform the following operations:

providing data to display on a video device positioned at a nursing unit located remote from a pharmacy a graphical user interface including a nursing unit-level electronic medication administration screen having electronic medication administration record data to allow medication administration entry by an authorized nursing unit member; and

providing an alert to the nursing unit indicating a modified electronic medication order.

61. A computer readable medium as defined in claim 60, wherein the instructions that, when executed by the computer, cause the computer to provide an alert to the nursing unit indicating a modified electronic medication order further cause the computer to perform the following operations:

providing automated highlighting of modified orders on the nursing unit-level electronic medication administration screen responsive to entry of the modified electronic medication order; and

providing automated printing of modified orders on a nursing unit printer responsive to entry of the modified order.

62. A computer readable medium that is readable by a computer to enhance pharmaceutical administration by medical personnel within a medical institution, the computer readable medium comprising a set of instructions that, when executed by the computer, cause the computer to perform the following operations:

providing data to display an administration schedule on a nursing unit video display device auto-refreshed at a preselected time interval to allow automated screen shifting along a medication administration timeline; and

providing an automated alert indicating existence of a modified medication order.

63. A computer readable medium defined in claim 62, wherein the instructions that, when executed by the computer, cause the computer to provide an alert to the nursing unit indicating a modified electronic medication order, further cause the computer to perform the following operation:

providing automated highlighting of modified orders on the displayed administration schedule responsive to entry of the modified electronic medication order.

64. A computer readable medium that is readable by a computer to enhance pharmaceutical order entry and administration by medical personnel within a medical institution, the computer readable medium comprising a set of instructions that, when executed by the computer, cause the computer to perform the following operations:

receiving a posting of a medication administration for an unscheduled medication order in a graphical user interface;

performing an automated creation of an electronic medication order for the administered medication order responsive to posting the medication administration; and

providing a special queue for a pharmacist to review and verify electronic medication orders created through posting a medication administration.

65. A computer readable medium that is readable by a computer to enhance patient medication management by medical personnel within a medical institution, the computer readable medium comprising a set of instructions that, when executed by the computer, cause the computer to perform the following operations:

determining if any of a plurality of medication orders for inpatient residents at a medical institution are about to expire within a preselected time period;

providing automated stop notification to a computer associated with a physician responsible for a medication order scheduled to expire within the preselected time period; and

providing a physician work queue requiring the notified physician to at least one of extend the medication order or confirm the medication order stop time.

66. A computer readable medium that is readable by a computer to enhance pharmaceutical order entry by medical personnel within a medical institution, the computer readable medium comprising a set of instructions that, when executed by the computer, cause the computer to perform the following operations:

integrating inpatient and outpatient medication orders stored in memory of a computer to provide a single patient medication profile for each patient of a plurality of patients; and

providing data to display on a physician video display device the single patient medication profile.

67. A computer readable medium that is readable by a computer to enhance pharmaceutical order entry by medical personnel within a medical institution, the computer readable medium comprising a set of instructions that, when executed by the computer, cause the computer to perform the following operations:

providing data to display on a physician video display device a graphical user interface including a medication order template having entry fields to allow electronic medication order entry by a physician;

providing data to display on the physician video display device at least one of a clinical and a non-clinical alert when encountered, responsive to the electronic medication order entry by the physician; and

performing automated intervention logging responsive to the physician overriding the alert.

68. A computer readable medium that is readable by a computer to enhance pharmaceutical order entry and administration by medical personnel within a medical institution, the computer readable medium comprising a set of instructions that, when executed by the computer, cause the computer to perform the following operations:

providing data to display on a physician video display device a graphical user interface including a medication order template having entry fields to allow electronic medication order entry by a physician;

providing data to display on the physician video display device at least one of a clinical and a non-clinical alert when encountered responsive to the electronic medication order entry by the physician;

providing an entry field in the graphical user interface to post a reason for the physician overriding a displayed alert; and

providing data to display on a pharmacy clinical workstation video display device the medication order entered by the physician and any clinical and non-clinical alerts encountered by the physician along with overriding reasons posted with the alerts.