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We did this and yes the age, gender, problem interaction warnings seemed to have stopped. This didn't help much though, our users are still seeing a ton of warnings for other types of interactions so we may as well just turn it back on and probably will. The most frustrating part of this seems to be when receptionists who do phone notes etc. get the warnings and have to have a physician address the interaction before the it can be signed. It even happens in completely empty notes where nothing has even been done. Maureen from GE told us today that it is because the upgrade changed our interaction settings in go, setup, settings, chart, drug interaction but we know these did not change. She is looking into it but no word back yet though.
Posted : August 26, 2014 12:05 am
Topic starter
Hi, I'm looking to see if anyone has disabled the medication interaction feature in the JMX Console on jboss. And if so, what has been your experience? We are thinking about disabling this until the issue is fixed with GE, however, we have not been able to test it on our demo because it's not on SP4. It seems like a pretty simple process, but we are just a bit hesitant to test it out on our live environment first and risk causing further problems.
If this is disabled, do the interactions (or box) completely go away? Or does it just get rid of some of them?
Thank you!
Natalie
Posted : August 26, 2014 12:05 am
Topic starter
Thanks Stacey. That's good feedback. When you did make the change, did it go fairly smooth? Or did you test it before making the change in your live database? I was trying to get more information about what this change actually does, but the reps that I talked to at GE did not seem to know the exacts and just sent me the information that's included in the SP4 release notes. I thought that it would completely disable ALL interactions, but if it's not, and the user is still getting incorrect information, then it may not be worth it to change it. We have kept the default settings for the med interactions (since CPS 10) and have never had to look at them until now. I've tried changing the 'minimum thresholds' around, but that seemed to bring up more interactions than before. I would like to know what thresholds should be chosen to include the least amount of interactions for the user. However, the first ticket I placed for this issue, the GE rep stated that there is no work around and this should be fixed in 12.1. I hope they get this fixed soon!
Posted : August 27, 2014 6:34 am
How about if there are no changes made to meds within the document you are trying to sign (phone note, release of info, etc) then don't prompt to override the interactions? They've taken one of the most important features in any EMR and completely butchered it to the point where people are disabling it or ignoring it.
We've had to make all sorts of lame workarounds and basically allow non-clinical people to do overrides just to get their job done and sign a document.
Posted : August 27, 2014 11:43 am
The jboss change is really easy to do and quick, and you could always reverse it if you don't like the results. The change is done on the app server using IE and the SP4 notes explain it pretty well. It really didn't help much though. This issue does happen if no changes are made to meds, users are prompted even if absolutely nothing was done in the document. The other hospitals I have talked to are disabling their interactions under go, setup, settings, and keeping some settings under user preferences. We don't really want to do this with MU requirements, since users can change their own settings back. It took three days to get it but now I have a ton of documentation to read through today that GE sent last night so I will let you know if I find out more.
Posted : August 27, 2014 9:26 pm
Are we even sure that these changes affect Overrides?
Everything in the Release Notes reference "Interactions", but does one really mean both?
Posted : August 28, 2014 5:31 am
You may want to test to be sure, but I think our systems analyst that tested had said they do. Here are the four SPRs related to interactions GE gave me if anyone needs them.
SPR # 59511—Absolute Drug-Drug interaction checking warnings higher than what is appropriate.
#59711 - Users are being prompted to override drugs if the minimal drug override threshold has been lowered prior to the new Update being created.
SPR # 45797 - User prompted to provide override reason due to contraindication with Ethanol / Alcohol. The Workaround is: User MUST provide override reason to continue.
SPR # 50042 - Users are being prompted to override drugs if the minimal drug override threshold has been lowered prior to the new Update being created. WORKAROUND: override the medication or forward the update to a provider to override the medication.
Posted : August 28, 2014 9:24 pm
We are hosted with GE, so we are at the mercy of Hosting Services for any JBOSS updates, but we finally had GE change the JBOSS settings to FALSE for gender, age and problem interactions because our providers could not stand the ridiculous interactions (alprazolam contraindicated for anxiety???). We are pleased with the results, however, we still get triggered for every food and ethanol interaction. I take it that SPR has yet to be addressed...
Posted : October 30, 2014 4:31 am
