Pharmacy database for tracking drug costs and utilization

A pharmacy database for tracking drug costs and physician prescribing trend s is described. Accuracy problems plagued data systems used to make drug-use-policy decisio ns at a tertiary;are teaching hospital because of structural deficiencies w ithin the systems and their nonclinical orientation. To resolve these probl ems, a programmer analyst, a clinical supervisor, and a clinical pharmacist developed a hierarchical database of drug costs. The database was designed to be valid for tracking drug costs according to patterns of clinical use. Internal controls were created that could identify and correct cost-tabula tion errors arising within the ordering, order-entry, and billing processes . The database was able to tabulate drug costs according to the clinical se rvice on which the patient was being treated at the time so that reports co uld compare aggregate prescribing trends from one time period to another fo r the same service; Similarly, the database could track and report drug use by disease or financial classification. Flagging elements were introduced to the database for cancer chemotherapy and antimicrobial drug products to enable reporting by these categories and by therapeutic subcategories withi n the antimicrobial category. Routine monthly reports were distributed to e nd users. Development of a database for tracking drug costs and utilization allowed a teaching hospital to derive the cost of medications from billing-charge in formation and to report data to health care professionals on the basis of i mportant factors like clinical services.