Week 7: Pharmacy-Specific Management Systems II, Medication Safety and Technology Flashcards
What is PharmaNet?
province-wide network linking all BC pharmacies to a centralized database
What are 3 enabling features of PharmaNet?
- access to consolidated patient records
- real-time drug dispensing information
- online claims processing and adjudication
What is the clinical significance of PharmaNet?
improves patient care and safety
- 32% reduction of inappropriate refills of opioids
- 48% reduction of inappropriate refills for benzodiazepines
What information is collected on PharmaNet? (5)
- prescription data
- claims data
- patient demographic info
- allergies
- other medical history (prosthetic/orthotic devices, non-prescription products)
(note: not all of the above data is available to all practitioners with access)
What are 3 possible examples of why a medication provided in BC may not appear on PharmaNet?
PharmaNet excludes data from:
- drugs given in a hospital or health centres
- samples from a clinician
- BC Cancer Agency, BC Transplant Society, BC Renal Agency
Where/who is PharmaNet currently available to?
- community and hospital pharmacies
- hospital emergency departments
- community health clinics (ie. family doctor offices)
- providers of medical devices and supplies (for billing claims)
- Ministry of Health and Health Insurance BC (for payment info)
- PharmaNet Prime allows the possibility for other providers to access, including pharmacists outside of dispensing roles, naturopathic doctors, midwives, optometrists, etc.
Is PharmaNet an optional service for any prescriptions filled in BC?
NO – patients cannot ‘opt out’ of PharmaNet
How can a patient restrict access to their PharmaNet profile?
can restrict access using keywords
What are the 3 security features that limit and monitor PharmaNet use?
access is protected by firewall requiring:
- access granted by Ministry of Health
- signed confidentiality agreement
- unique identifier prior to access every time
What are the names for PharmaNet modernization?
- previously referred to as ‘PharmaNet 2’
- more recently called ‘Gen 3’
What is the goal of PharmaNet modernization?
to improve delivery of patient care by expanding electronic medication information management to facilitate care
What is the pharmacist-specific goal for PharmaNet modernization?
platform for pharmacist clinical services
What are the proposed/claimed updates for pharmacists in the next update to PharmaNet?
- dispense electronic prescriptions in addition to paper prescriptions – change prescription ‘status’, document details of dispensed transaction
- billing linked to clinical services, such as medication management and adaptations
What are the proposed/claimed updates for physicians in the next update to PharmaNet?
- add sample medications
- download data from PharmaNet
- send electronic prescriptions
- search for prescriptions by prescriber
- check for adapted prescriptions
What is the Health Information Access Layer (HIAL)?
architecture system that allows multiple point-of-service systems to request and connect with others
- backbone of EHR systems
- NOT a repository of data
- ie. HIAL-based systems integration: long-term care, hospital, provider registry, lab information, diagnostic imaging, drug information, client registry, physician office
What are 2 services that HIAL systems should be capable of doing?
- act as central method for coordinating services across EHR systems in HIAL
- provide a secure and organized method of queuing and sequencing requests
Compare and contrast HIAL with one-by-one service systems and provide 2 reasons why HIAL systems may be better.
HIAL-based systems have:
- greater integration capability (less integration points)
- lower costs
What are the principles in medication safety culture? (5)
- errors cannot be eliminated, but can be managed or mitigated
- errors are opportunities for learning
- naming, blaming, and shaming have no value
- we cannot change the human condition, but we can change the conditions under which humans work
- ‘system’ approach vs. ‘person’ approach
What is human factors engineering?
study of how people interact physically and psychologically with products, tools, procedures, and processes
- working to make the environment function in a way that seems natural to people
Explain the three broad factors in human engineering to reduce medication errors.
- facilities and equipment – ergonomics, work space, design, maintenance reliability, physical characteristics (noise, lighting, toxics, etc.)
- people – human characteristics (physical and mental), human behaviour, fitness, stress, fatigue
- management systems – leadership, management commitment, change management, incident investigation, hazard identification, risk assessment, procedures, training
What is the hierarchy of effectiveness?
- high leverage (most effective)
- medium leverage (moderately effective)
- low leverage (least effective)
High Leverage (Most Effective)
- forcing functions and constraints (system-based) – ie. removal of a product from use
- automation or computerization (system-based) – ie. automated patient-specific dispensing
Medium Leverage (Moderately Effective)
- simplification and standardization (system-based) – ie. standardized paper or electronic order sets)
- reminders, checklists, double checks (person-based) – ie. independent double checks for high-alert medications
Low Leverage (Least Effective)
- rules and policies (person-based) – ie. policies to prohibit borrowing doses from other areas
- education and information (person-based) – ie. education sessions on high-alert medications
