Using Information Technology to Improve the Monitoring of Outpatient Prescribing

Figure. Graphic representation of data flow through the ISTOP monitoring system. (1) At the time of prescription, primary care physicians receive electronic prompt identifying eligible patients; this information is based on a query of the patient's prescription history within the clinical data repository. (2) When the patient's eligibility is confirmed and the patient consents, primary care physicians enroll consenting patients into the program. (3) The system's electronic health record (Medical Office of the 21st Century web-based electronic prescribing and integrated drug management [MOXXI] system⁶) passes data to the interactive voice response system (IVRS) to queue automated follow-up calls. (4) The IVRS calls patients and administers the questionnaire on days 3 and 17 after the prescription; the questionnaire consists of 4 simple questions soliciting “yes” or “no” answers (med indicates the subject prescription medication). (5) The IVRS passes patient response data to MOXXI to update the electronic health record. (6) The IVRS sends an e-mail to the study pharmacist if responses by the patient indicate that follow-up is required. (7) The pharmacist personally contacts patients and documents information in the MOXXI system.