Year 1: Convening Stakeholder Expert Panels—Completed Webinars

Panel participants included patient safety experts, pharmacists, physicians, EHR and compendium vendors, HIT and human factors researchers, PBMs, knowledge management experts, patient educators and patients. These groups functioned as both traditional expert panels as well as constituent representatives and broad input was solicited during the 90-minute webinars.

Panel 1: Delineating and Defining the Construct of Indications-based Prescribing

Chairs: G. Schiff, A. Wright, E. Seoane

Broad overview of potential benefits, risks, and challenges
How do we define "indication" (how concept overlaps/differs from diagnosis, labeled indication, uses, reason for use, medical problem/symptom, specific appropriate use criteria)
Historical, regulatory experience: past and present, U.S. and international national experience with I-CPOE
Policy implications for various stakeholders and ways to achieve consensus

Panel 2: Indications-based Prescribing and Patient Safety/Medication Errors

Chairs: D. Bates, M. Cohen, L. Leape

Rationale and role in preventing medication errors; wrong drug, patient, dosage, regimen, duration
Role in HIT safety in preventing errors caused or facilitated by CPOE design limitations
Role in detection of CPOE errors (by pharmacists, patients)
How to optimize interface and workflow design features to ensure safety and usability

Panel 3: Pharmacists and Indications-based Prescribing

Chairs: A. Salazar, F. Federico, M. Amato

Data and experience supporting pharmacists’ need for prescription indication
Role of indications-based prescribing for pharmacists in patient counseling
Practical logistics of indications-based prescribing for retail outpatient pharmacies
Putting indication on prescription label: pros/cons; exceptions; other logistics

Panel 4: Patient Education/Information and Indications-based Prescribing

Chairs: B. Lambert, A. Salazar

Communicating therapy indications to patients: rationale, methods, patient needs, experience
Educational/instructional leaflets
Empowerment; adherence; concordance issues
Translating medical indications into lay English, Spanish terms
Patient confidentiality issues and concerns

Panel 5: Drugs of Choice

Chairs: J. Lexchin, E. Seoane, G. Schiff

Drugs of Choice - historical and current concepts, constructs, content sources
Enabling prescribers to efficiently choose recommended medications; ordering by first entering indication
Prescriptive guidelines/guidance vs. clinical flexibility/autonomy
Capturing and learning from on vs. off label prescriptions
Formulary and choose wisely guideline connections
Role of indications in enabling prior-authorization processes

Panel 6: Health IT Technical and CPOE Design Issues

Chairs: A. Wright, P. Neri, A. Landman

Current capabilities and CPOE features and limitations of various systems
Front end, back end, interoperability issues
Knowledge management vendors’ capabilities
Optimal user-centered design requirements and issues
Policy issues/implications

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