May 4, 2021

Tennessee CSMD Integration with eStar and Updates

Tennessee CSMD Integration with eStar

Beginning May 12, the Tennessee Controlled Substance Monitoring Database (TN CSMD) will be integrated with eStar. This integration will help streamline clinician workflow (saving approximately 4.22 minutes and 52 clicks per patient) and support compliance with state law.

There is a regulatory requirement to check TN CSMD before prescribing:

  • Opioids or benzodiazepines
    • Before each prescription in first 90 days
    • Then every 6 months thereafter
  • Any II-V controlled substances clinicians suspect patient may be trying to obtain inappropriately

This change will impact pharmacists and all prescribers with DEA numbers who order controlled substances.

The new integration means clinicians can query the TN CSMD within their eStar workflows. They no longer have to separately go to TN CSM web portal, log in and manually search for the patient (includes patients with existing or new CS II-V prescriptions). The clinician clicks Review Pt’s CSMD within chart and reviews the Medication Dispense History report.

Prescribers and pharmacists may still use the web portal, which should be checked in the cases of eStar downtime. If the web portal is down, there is no regulatory requirement to check TN CSMD.

As required by vendor and state law, delegates (e.g., nurses and MAs) will still need to use the web portal.

The TN CSMD is only available for locations within the state of TN.

View Quick Start Guide “Accessing TN CSMD in eStar” (available in Hubbl) for more information.

A Learning Exchange module titled, “How to prescribe opioids in eStar” with two short videos (less than two minutes each) has been created as a resource for prescribers highlighting the new CSMD eStar feature. The videos, along with many other controlled substances prescribing resources, are also available via the Opioid and Controlled Substances Reference Information for VUMC Employees website. For any specific questions on opioid prescribing, you can email opioidinfo@vumc.org.

 

eStar Updates and Changes

Lab Orderables for Cytology & Cytopathology

Beginning May 5, there will be new Lab-ready labels for the following cytopathology and cytology lab orderables:

  • Cytopathology Non-Gyn/FNA
  • Cytology Urine

These will help ensure cytology samples are routed properly and will impact all users who order or collect/prepare specimens for cytopathology and cytology lab tests.

Lab-ready labels should be placed on specimen container or in specimen bag if it is a shared sample. Cytology orderables will still need:

  • Collection task completed in eStar
  • Accompanying paper requisition

See the following Tip Sheets in Hubbl for more information:

Updated Names for Lab Orderables

Beginning May 5, the following lab tests will have new names:

  • CYCLOSPORINE LVL [LAB874]
  • TACROLIMUS LVL [LAB876]
  • SIROLIMUS LVL [LAB875]

The updated names will now contain “trough” as part of name:

  • CYCLOSPORINE TROUGH LVL [LAB874]
  • TACROLIMUS TROUGH LVL [LAB876]
  • SIROLIMUS TROUGH LVL [LAB875]

This change will help alleviate potential errors when administering medications (trough is needed beforehand) and will clarify timing for lab draws.

Users should update user preference lists as needed based on the name changes.

 

Removal of “Sedation” from MRI Orders

Beginning May 5, the “sedation” option will no longer appear when placing an order for an MRI. User should instead select “Anesthesia” if patient requires any type of sedation or anesthesia. The appropriate resources will then be scheduled. This change is necessary to properly assign anesthesia resources and will impact all users who place orders for MRIs.