Week 6: Pharmacy-Specific Management Systems I, Clinical Systems Transformation Flashcards
What is the goal of medication distribution systems?
timely and accurate supply of medication for administration
What is the goal of medication administration systems?
help the 5 rights – patient, drug, dose, route, time
List and explain 2 examples of how medication distribution and administration can be controlled by healthcare providers in the outpatient setting.
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Medication Distribution and Administration in Community Settings
- based on individual pharmacies
- distribution: daily/weekly dispense, daily witness
- administration: patients administer meds on their own (vials, blisterpacks)
- community IV programs
What are the pros/cons of medication distribution and administration impacting the way technology is used in community settings?
- leaves treatment ultimately up to patient (ie. adherence)
- allows for other ‘dispensaries’ or providers to add/remove therapy
- monitoring becomes responsibility of patient
Medication Distribution and Administration in Institutional Settings
- different charting/EHR systems
- patient-controlled administration (ie. PCA)
- MD/Nurse initiated and administered ward stock
What are the pros/cons of medication distribution and administration impacting the way technology is used in institutional settings?
- med administration is controlled and tracked
- compliance is expected but not necessarily enforced
- if system fails in one area, it can affect entire circle of care
What do MARs include? (2)
- medication information (ie. name/strength/dose/route)
- day and time for when medication is administered and who gave it
What is a traditional MAR?
- requires updating after every new order
- not always easy to locate if being used by others
- not always designed to have comments or explanations (ie. when patient refuses dose), can cause legibility problem
What is an eMAR?
- can sync for automatic updating
- can be linked electronically to the correct patient and drug (ie. barcoding)
- other small features that are helpful (ie. reminders, colourcoding, alerts, etc.)
What is a closed-loop medication system?
system that uses technology/automation to close the inpatient medication management and administration ‘loop’
- encompasses the entire medication ‘journey’ from ordering to administration
- critical for safety, other electronic tools, and efficiency
What are pharmacy prescription systems (pharmacy practice management systems)?
- historically used to support dispensing and billing
- PharmaNet approved vendors published online – ie. Applied Robotics, Kroll, ProPharm/Nexxyx, Telus Health
What is NAPRA (National Association of Pharmacy Regulatory Authorities)?
set 35 requirements for all PPMS’ including ability to:
- create a unique patient record
- have a comprehensive med profile
- allow for clinical records
- integration for lab tests
Provide examples of the processes and features of PPMS including patient information and drug modules including inventory management.
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What is the goal of inventory systems?
minimize total cost of inventory by maintaining optimal stock quantities
Why does it matter to know optimal pharmacy stock levels?
consider that pharmacy inventory…
- stock can be very expensive
- shelf space is limited
- expiry dates are not guaranteed
- time for staff to receive/shelf orders
- shortages occur, not having stock impacts patient satisfaction
- government can change what brand is covered
- increase risk of theft
- money can be spent elsewhere
What can pharmacies do with a good inventory system?
- the potential: paying for an item at cost and selling it before you need to pay for it (pharmacy vendors allow purchases of stock with various delayed payment methods)
- the alternative: you do not sell the product and you eventually need to pay the vendor
What are wholesaler-monitored inventory systems?
- requires wholesaler to have access to your stock numbers – requires accurate stock numbers including damaged/stolen/expired items
- wholesaler will send you stock to maintain a ‘minimum quantity’ – can flag sales trends for you
What are store-monitored inventory systems?
- requires vigilance and monitoring by staff to ensure stock levels are maintained
- can be slow to respond to changes in sales
What is automatic identification and data capture (AIDC)?
automated process of verifying objects or service steps, allowing for the collection of key information throughout a process
- includes bar codes, RFID (radio frequency ID) tags, other tags that can be scanned/read/interpreted automatically
- key enabler for inventory
What is barcoding?
GS1 global AIDC standard adopted by Canada
- different barcodes allow for different pros/cons
- one of the key elements of good medication distribution and administration
- can cost millions $$ for large organizations to adopt barcoding
- implementing barcoding means you need to do it every step of the distribution/administration process
What are the characteristics of different barcodes? (5)
- allowable length of barcode
- alphanumeric
- omnidirectional
- auto-correcting feature
- two-dimensional lines
What are the various elements required for barcoding? (3)
- barcode scanners
- barcode printers
- barcode software and database on your server
What are the 3 key principles of Generation 2 (GEN 2) Drug Information System (PharmaNet)?
- all drugs all people – typically excludes OTC products, herbal medications, and physician samples
- online viewing of patient’s medication profile (dispenses) by pharmacist or prescriber, regardless of location
- network level adverse drug reaction screening
What is CeRX?
the Pan-Canadian Electronic Drug Messaging Standard for Drug Information Systems
- HL7 v3
- non-financial, clinical messaging standard
- used in provincial DIS network implementation
