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4/1/24 Documenting and verifying Non-Formulary Home Infusions
April 1, 2024
Hey fellow pharmacists!
As a follow-up to Aaron’s information on the new **Pharmacy Only** option for home treprostinil (Remodulin) infusions, I can’t recall how well we distributed the education on general, non-formulary home infusions (including pain pumps), both how we want them documented on the home med list (e.g. by TOC), and how they are to be Voided and re-entered inpatient as an actual infusion OR as TNF Continuous orders.
Please see the PDF at the following link for this information: https://docushare.hhsys.org/dsweb/Get/Document-108400/Entering%20and%20Verifying%20Non-formulary%20Home%20infusions%20and%20Pain%20pumps%20for%20Inpatient%20use%20v2.pdf
In summary:
- We want most home infusions documented on the home med list as “Home Pump” options
- If continued in the hospital, these TNF Medication orders should be Voided and replaced with formulary infusions whenever possible, and if not as “Pharmacy Only” options or TNF Continuous
- Why not just resolve the Home Pump listing directly to TNF? Because Cerner does not allow Continuous medication types to be documented on the home med list. If directly verified, the TNF order would show up in the wrong section of the MAR.
- TNF Continuous is just an inpatient placeholder, so there won’t be any clinical checking. We tried to create this option that was less burdensome for pharmacists, but still provided information for the chart. If you have concerns about the safety of a home infusion that is not built out, please contact Med Safety/PharmIT.
- The information on how to handle specific non-formulary home infusions like treprostinil (Remodulin) has been incorporated into its drug listing on Formweb: https://formweb.com/master/display.php?dir=hhsys&thedrug=Remodulin. Thank you to Aaron Smith for bringing this issue to our attention.
The complete PDF has also been added to Formweb under the Cerner master Tip Sheet document. As a reminder on where this lives, navigate to the PharmIT subpage on https://formweb.com/hhsys, and click on the first link (see below for screenshots). This document can be searched via CTRL+F and contains almost every Cerner tip sheet our department has ever created, including some that describe how to handle specific medications. We are always open to your feedback on its contents, and try our best to keep it updated with any changes.
Please send over any additional questions or thoughts, as we are open to improving the process.
Thanks so much and have a great holiday weekend!
Joseph Ho, Pharm.D.
Clinical Pharmacist - Transitions of Care
Lead Pharmacist - Cerner Pharmacy Education
Huntsville Hospital
joseph.ho@hhsys.org
cell: 504-214-7705
office: 256-265-9854