Better Meds is a closed-loop medication management system developed to replace paper-based processes for reconciliation, prescribing, pharmacist review and medication administration. Impressed by the capability and recognising a significant opportunity in the market, Alcidion partnered with Better in 2019 to resell their Better Meds solution in Australia, New Zealand and the United Kingdom.
Since then, Alcidion has implemented Better Meds in United Kingdom National Health Service (NHS) Trusts and has a project underway with New Zealand District Health Boards (DHBs). The workflow and underlying requirements are shared in Australian practice including the structure of the Australian Medicines Terminology (AMT).
There is significant evidence published in all regions about the benefits that can be realised through the adoption of electronic medication management (eMM). By using eMM, healthcare organisations can reduce the number of preventable adverse medication events and medication prescribing errors. eMM also improves the accuracy, visibility and legibility of medical information, so that the communication between healthcare professionals is clearer and not prone to transcription error.
Better Meds is fully embedded in the Alcidion solutions as it fully utilises Open Standards, allowing the most advanced clinical collaboration so users have the appropriate clinical data available to them when prescribing and administering medication. Access is available directly from the Alcidion product suite. For example, providing the ability to launch from Miya Flow during ward discussion and the Miya Observations (Patientrack) when carrying out other nursing tasks.
In the following, we describe the key workflow steps in eMM and the support provided by Better Meds in conjunction with the Alcidion suite of products:
Reconciliation
By creating an accurate list of all medications a patient is taking, medication reconciliation can be done at critical stages of the patient journey, from admission, throughout inpatient care, right up until discharge. Better Meds compiles an up-to-date list of medications on admission from direct access to different prescription sources such as previous admissions and outpatient attendances supporting clinicians to include or edit medications from sources to produce the “best possible” Medication on Admission List.
In New Zealand, this includes the New Zealand ePrescription Service (NZePS) data feeder as an information source for patient medication prescribing/dispensing history. In the UK, future integration with GP Connect for the extraction of prescriptions in General Practice systems and integration to the Electronic Prescription Service.
On discharge, the Reconciliation step automatically generates a Discharge Summary (reconciled list) highlighting new, changed and unchanged medication status, to ensure safer transfer of care. The complete medication list is shared with Miya Precision and the detailed drug information can be referenced in Clinical Documentation and Clinical Decision Support.
Prescribing
Supporting the “Five rights of medication administration” (right patient, drug, time, dose and route), the Prescribing step allows the clinician to create appropriate, effective and safe prescriptions through an advanced, embedded decision support with only a few clicks.
For the NZ environment this includes medication data, APIs and links to medication monographs provided by the New Zealand Formulary (NZF) and New Zealand Universal List of Medicines (NZULM). The UK has all medication data mapped to the national sources of dm+d and SNOMED. The customer can specify their requirements, properties and rules to aid safer prescribing along with the enhanced CDS Electronic Prescribing brings to clinicians.
This step improves communication and transparency across clinical team members, provides a clear and concise visual organisation of prescription and administration details, has an embedded dose calculator tool to assist in defining a patient’s dose, offers a guided selection of appropriate prescriptions based on current conditions via order sets. Finally, a “Prescriber Task List” can be accessed with “one click”. Alcidion solutions enabling Prescribers to efficiently view outstanding medication actions or reviews required.
Pharmacist Review
Better Meds Pharmacist Review capability provides comprehensive paperless support for the clinical pharmacist review process with standardised electronic forms for intervention logging, supply requests, reminders and prescriber comments.
This critical step improves workflow and collaboration between clinical teams by worklists for new or changed prescriptions, reminders, supply requests and reports for clinician verification; reduces Adverse Drug Events (ADEs) and other “never event” occurrences by formal pharmacist review of prescriptions as well as provision of reports for prescribers; automates generation of lists for clinical pharmacist activities; creates secondary use of all structured data for reporting; and the optimisation of work processes.
Pharmacist and Supply Request Task Lists are accessible with “one click” from Miya Observations and Miya Precision to further streamline workflows.
Medication Administration
Designed to help clinicians administer and record the correct medication and dose to the right patient, the Medication Administration step enables the creation of daily plans based on schedules with the Medication Administration Task List accessible from Miya Flow and Miya Observations, those medications due for the day are readily visible, with due/overdue items highlighted. Schedules can be aligned with the patient location and adjusted per individual as appropriate.
This step provides clear and comprehensive tracking and alerting of all changes to medication orders, issues medication administration reminders and prioritisation and automatic task generation, supports barcode scanning and advanced administration scenarios streamlining the process for ordering stock with integration to the pharmacy system.
Integration of these solutions means that clinical staff have full context of the patient status at the critical time of administering medication.
Discharge
The medication discharge process has been simplified due to an automatically generated reconciled prescription list on discharge. This process collates all relevant medication information gathered during the patient stay for inclusion, as required, in discharge correspondence.
Supported on desktops, workstations on wheels and tablet devices, the immediate discharge summary can be exported at any point into a format that supports various international standards, enabling wide-scale access to patient medication details from remote locations. It can also be shared to populate any existing discharge summary capability.
Better’s Electronic Medication Management solution has integrated with Alcidion’s products seamlessly, offering our customers an intuitive and streamlined way to manage the medication requirements of their patients at all stages of their care journey. Click here to find out more about Better.
Angela White is a Senior Implementation Consultant and Nick Bigland, Implementation Lead at Alcidion.