Like many hospitals and healthcare systems, Duke University Hospital’s online formulary consisted of a spreadsheet housed on the intranet. The spreadsheet only listed medications that were considered formulary, and there was no information provided concerning associated restrictions, policies, or guidelines. This information was not readily available or easily retrievable for nurses and other staff members. 

A hospital’s formulary initially consisted of a simple book of medications approved for patient use in that particular organization. When hospitals made their formulary available online in the late 1990s, it was basically the same book, but now on a computer screen.