First dose improvement

How one hospital decreased Order to Pharmacy-to-Dose response times

Edmonds, WA., June 30, 2021

A pharmacy group from a hospital in Ohio contacted M2 to assist them in establishing a Pharmacy-to-Dose alert and messaging system between pharmacists and providers prescribing Vancomycin and Aminoglycosides.


Medications with narrow therapeutic windows (where the dose needs to be very precise) are more likely to cause adverse events and may be more prone to medication errors. Dosing decision-support may therefore be of particular-value for high-risk medications (such as vancomycin and aminoglycosides).

Pharmacy-to-dose clinical decision support includes the prescription itself, monitoring for laboratory tests, as well as patient-specific characteristics and physiological parameters including age, weight, and renal function.

Monitoring for at-risk patients and collaborating with clinical pharmacists can be a very complicated communication challenge in hospitals. Automating these requests and expediting time to prescription and dose corrections can save lives. Traditional, legacy EHR’s are often not set up to send alerts/notifications and interfacing them with a mobile platform to automate this information delivery is ideal.


M2 clinical and technical staff worked with the hospital pharmacy director to create a notification group that was alerted when a patient was prescribed Vancomycin or Aminoglycosides. Pharmacists were able to act upon the notification immediately and calculate the dose of the drug. Pharmacists were also notified (automatically via MBMD) of patient time on medication dose and monitored for laboratory results.


Automating requests for clinical pharmacists to provide medication-related clinical decision support decreased time for pharmacist to complete the PTD prescription.

MBMD facilitated medication turn-around times for first doses of vancomycin or aminoglycosides and for first doses of any antibiotic, dose adjustment for renal dysfunction, medication errors, and time of order entry.

About M2

M2 Information Systems, Inc. is based in the Seattle area and has been developing, installing and supporting hospital applications in the U.S. for 30+ years. M2 began developing PC based order management and resulting systems for hospitals in 1983. In the early 90’s they focused exclusively on clinical workflow applications for larger facilities. M2 developed the first hospital web-based clinical systems and has now coalesced that knowledge and experience into MicroBloggingMD (MBMD). Additional information is available at:

About MicroBloggingMD

MicroBloggingMD is a clinical event driven, mobile alert and messaging technology with intelligent and customizable decision support. Subscriptions are used to generate specifically configured messages for clinical events with suggested best practices or standards based responses. All information is processed and delivered via a secure, patented conduit to the centerpiece of the application, MicroBloggingMD. The microblog is accessible via most mobile devices, smart phones or tablets. Additional information is available at

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