Many leading hospitals are embracing advanced medication decision support as a key enabler in their digital maturity journey. They are driving changes across the entire care continuum, from improving patient care to reducing clinician alert fatigue.
World Health Organization has been recognizing the magnitude of medication mistakes for many years. They are considered a major cause of harm and injury to patients within healthcare systems. They cost healthcare providers worldwide an estimated 42 billion each year.
Many hospitals have invested heavily in Best EHR systems. However, due to their lack of integration with EMRs and unaligned workflows, they rarely provide support at key touchpoints during the patient journey.
A survey carried out by the European Collaborative Action on Medication errors and Traceability, (ECAT), among European hospitals found that while 94% of them have electronic prescription systems in place, only 20% are integrated with Clinical Decision Support Systems. The existing technology is not used effectively to combat medication errors.
A widespread problem
Christian Cella is vice president of Wolters Kluwer’s Clinical Effectiveness. He says that the problem of medication mistakes is widespread.
The problem exposes weaknesses throughout the patient’s journey, ranging from suboptimal automation to the lack of integration of comprehensive data on drugs within the EMR.
This could reduce alert fatigue and increase patient safety. This also negatively impacts the efficiency of prescription workflow.
In some regions, the government either underestimates or ignores this problem. He says that it should be part of a digitalization program for public and private healthcare.
Cella says that even digital solutions, when implemented, are not adequate for the job. Cella says that sometimes they can create what he calls a “boomerang”.
They are too busy to create specific alerts, so they send out generic ones. Doctors are annoyed with the information. It can lead to a condition called ‘alert fatigue’ where clinicians begin to ignore or override critical alerts.
These systems contribute to clinician burnout, instead of supporting them through the decision-making processes. It is not the way it should be.”
If they place advanced medication decision-support at the core of their digital maturity strategy, hospitals can improve patient safety and care quality. The benefits of this can go beyond the immediate improvement in patient experience.
It will improve the decision-making of clinicians if an advanced medication support system is fully integrated into the hospital’s EMR workflow and prescription workflow. The hospital will also be able to save time and improve efficiency throughout the entire care continuum.
Cella claims that integrating digital maturity models such as EMRAM 7 with precision medicine will drive adoption of technology for clinical decision support. It is important that it shifts digital maturity assessment from a process audit to a measurement of the impact of medication decisions support by data tracking.
Prospective patients will feel safer if hospitals demonstrate how they effectively manage patient risks.
Rise to the Challenge
Wolters Kluwer’s Medi-Span(r), Clinical APIs drug data solution and expert services are built around the precision and quality of alerts and the integration with workflow to support decision making. This ensures that accurate information is readily available at key touchpoints and not just reported after an event.
National Cheng Kung University Hospital in Taiwan used Medi-Span clinical APIs to solve specific challenges that its pharmacists and clinicians faced. One of the biggest challenges facing pharmacists is how much time it takes them to update and maintain a medication database.
It is easier to do this by using a platform that is supported by a team of multidisciplinary editors who ensure the content is current with best-practice recommendations and evidence. Medi-Span databases are updated continuously so that users can access a global perspective of current regulations, safety advice and medication use.
NCKUH has found that the use of advanced technology for medication support, led by a team dedicated to the cause and supported at all levels within the hospital, can help reduce errors and improve operational efficiency.
Results that are promising
Since implementing Medi-Span, the hospital has found that alerts were reduced by 21 percent and alerts captured more serious potential Adverse Drug Event (ADE) cases. The hospital saved NT$558,000 (new Taiwan dollars) in a period of five months, which is equivalent to NT$1.39 million (US$39,200) a yearly.
The reduction of ADEs saved approximately 111 bed days in the same time period. This is equivalent to 266 beds days a year.
Director of Pharmacy Cheng Chinglan at NCKUH says that maintaining medication safety is the most important job for pharmacists. This system’s advanced features will be invaluable for supporting clinicians in their decisions, reducing fatigue and improving clinical efficacy. “I look forward to seeing big improvements in pharmacies in Taiwan with the successful implementation at NCKUH.”
Saudi Arabia’s digital health strategy, which focuses on improving patient care, is also based around giving users of the system access to a centralized information source for standardizing drug administration and customizing and minimizing alerts. This is an excellent example of a best practice approach in digitization and care for patients that is guiding the Kingdom’s efforts to achieve HIMSS EMRAM 7.
Medi-Span is now used by many healthcare providers and other rcm companies, including the majority of leading hospitals in the private sector and more than 30% of Saudi Ministry of Health Hospitals. The advantages of moving to a cloud-based standardized model for the entire prescription and drug management process are influencing hospital and national strategy.
A Unified Approach
“The system provides us with a standardization,” said Dr. Saad Nofai. He is the director of corporate clinical information systems and acting director for health informatics at the Ministry.
“Medication history, references, and precautions are all part of a dynamic information chain. Nobody can remember it all. We now have a trusted source. “We are working to reduce the error to zero and we’re almost there.”
He recommends a committee-based implementation of an advanced clinical drug screen system to ensure that it meets the requirements of all clinical stakeholders – creating a hybrid organization between clinical specialty, and IT specialty.
He says, “This isn’t a technology issue – it’s a science.” It brings together the IT expert, the informatics professional, the IT specialist, and the pharmacist to cover every aspect of automation.