Electronic Medication Management Records Flashcards
Why have electronic patient records?
- Patient centred clinical decision making and care coordination –> connectivity, integration, interoperability –> access to more complete data, redcuing fragmentation of care
- Efficiency: evolution towards paperless systems with ubiquitous access
- Cost saving (eventually): huge investment, but ultimately reduced duplication (or over servicing), prevention of under servicing, and more timely xare
- Data security despite privacy concerns and hacking threats
- Capacity for big data research via data linkage between patient record and Medicare data, hospitalisations, PBS data, disabiltiea services etc (using secure identifiers)
What does My Health Record (MHR) include?
What is the MHR?
A secure online summary of an individual’s health information, available to all australians from birth to death
Accesible to authorised healthcare providers to view and add to
Supplements existing health records with a high-vlue, shared source of patient information that can improve care planning and decision making
What was MHR introduced as?
Introduced as the personally-controlled electronic health record (PCEHR)
What are the potential used of the MHR at different stages of life?
- Antenatal record
- Mental health
- Health checks, immunisations
- Allergy checks
- Prescribed medicines (any age)
- Discharge summaries; medical info integrated between hospital and GP (any age)
- Diagnostic and monitoring results (any age)
- Advanced Care Directives
What are documents entered by healthcare providers in My Health Record?
- Diagnostic Imaging Reports
- Discharge summaries
- e-referrals
- event summaries
- pathology reports
- shared health summaries
- specialist letters
What medicines information found in MHR?
- Allergies and AR and medicines information
- prescription and dispense record
- medicare overview
What are limitations of the MHR in regards to quality of data?
Incomplete/inadequate quality of data
> cant tell if patient has hidden hisotry
> time required to build a usable volume of data for a complete picture of the patient –> need a critical mass of content to make the MHR attractive and comprehensive enough to use, relies on practitioners to build up this critical mass
> obligations relating to uploading of records, the allocation of liability between the parties, and the processes for notifying key events and changes are covered in participation agreement
> media reports of GPs seeking legla advice about liability for incomplete and inaccurate data in a patients MHR
What are limitations of the MHR in relation to integration with other systems?
Sit externally to most dispensing software, requiring switching of platforms and login to MHR cf true integration
What are some general limitations of MHR?
- Patients may view lab test results uploaded before next Gp appt
- Need for integration with dispensign workflow, especially if technicians enter data and alerts are raised
- Additional administrative tasks on burdened health professionals, largely clerical documentation, impeding workflow and communication with the patient
- Requires standardised terminology (australian medicines terminology –> move to internationalised spelling of medicine names) and coding of medical conditions
- Information transfer does not constitute communication and vice versa
Privacy concerns with MHR?
Access to MHR is data lodged, so ensure only authorised access for the purposes of direct patient care (patients can receive SMS or email notifications of each access)
What is the pharmacy role with the MHR?
- Obtain timely access to valuable clinical information and to patient-entered information
- Reduce time spent gathering information from multiple sources –> more complete picture
- Provide tailored advice based on relevant and recent information
- Enhance delivery of MedsChecks, HMR, RMMR, QUM, medication reconciliation
- Improve continuity of care
- PSA MHR guidlelines –> including correction of errors
What pharmacy registration requires eRx Script exhange?
MedView Medicines Workspace (by FRED IT) integration with MHR medication data (complementary systems at high-risk intersections e.g. discharge and community pharmacy
Where to from here?
- How MHR can improve post-discharge medicaiton management
- Use of digital health records in clinical decision making and patient safety spanning healthcare settings
- MediTracker app to empower health consumers to access MHR, connet with GPs and pharmacists, and share data
What are some other electronic medication management symptoms?
Hard-copy charts –> national inpatient medication chart
Hybrid (paper-light)
digital (paper-less) –> by 2022 (national digital health strategy)
What is BOSSnet? What does it facilitate investigation of?
Facilitiate investigation of incidents and system failures using root cause analysis, why-because, and cause-and-effect analysis
What are potential problems with electronic medication management systems?
Need for constant switching between screens or tabs –> fragmented cognitive images of a patient case cf single tangible chart
Potential inflexibility in charting medication
> one dose of the day already administred before discontinuation –> can this be appropriately recorded?
> delays in meds administration due to late delivery from pharmacy
> can urgent medication orders be administered and documented before the medicines is charted in the system
Genral comments with risk management
Summary
