Electronic medication management A guide to safe implementation (3 rd edition) Herbert Down CHIA Project manager, ehealth and Medication Safety
Required reading
National Safety and Quality Health Services Standards Accreditation standards for health service organisations Version 2 was approved by Australian Health ministers earlier this year For further information: https://www.safetyandquality.gov.au/ourwork/assessment-to-the-nsqhsstandards/
Safety in ehealth
Program of work in ehealth My Health Record safety program including 14 clinical safety reviews Tall Man Lettering, High risk medicines Presentation of clinical information EMM Guide
Version 1 of the EMM Guide Oversight by an EMM Reference Group Based on the experience of three early adopter sites Incorporated lessons from the EMM Literature Included EMM specifications Excluded specialty-specific medications Included an EMM implementation template Endorsed by Health Ministers in Sept 2011
EMM Guide 2 nd Edition 1 Consultation with additional EMM sites Including private hospitals Independent desktop reviews Review workshop for all participants
Why revise the Guide? Expanded Australian experience Incorporate topics and clinical areas previously excluded Focus on governance and regulation Optimising EMM systems More than twenty implemented sites including paediatrics Feedback through the Commission s medication safety network
Preparing the 3 rd edition Round table of experts was convened in July 2016 to determine the extent of the required revision Literature review of EMM implementation in hospitals 2 and Commission publications 3 4 5 6 Extensive consultations Validation workshop Expert review including members of National Chief Clinical Information Officers and the Health Services Medication Expert Advisory Group
Consultation Public hospitals Prince of Wales Hospital, Sydney Concord Hospital, Sydney Maitland Hospital, Hunter New England LHD The Children s Hospital Westmead Austin Health Peninsula Health South West Alliance of Rural Health Royal Children s Hospital Royal Brisbane Hospital South Australian sites NT rural sites ACT Health EMM project Private hospitals St Stephen s Hospital, Uniting Care Macquarie University Hospital Epworth Eastern Cabrini Private Hospital Other stakeholders EMM Expert Reference Group members The Australian Digital Health Agency Professor Johanna Westbrook, Centre for Health Systems Research, Macquarie University Kerri Fitzsimons, WA Health The EMM Program Director, ehealth NSW Tom Simpson, Director ehealth, Tasmanian DHS Judith Mackson, NSW Health Ann Slee, NHS UK Jurisdictional Chief Pharmacists
What s new in the third edition? Recent EMM implementation experience Business continuity planning and operationalising the EMM system Policy & compliance and regulation Continuous quality improvement
Business requirements Aim to support EMM system procurement and product assessment Developed from published and unpublished information sources Some of the requirements do not reflect current capabilities of products in the Australian market
What hasn t changed? Four sections Instructions on how to use the Guide specific to each team member Useful checklists and task lists Emphasis on strong planning, procurement and benefits realisation Examples of project documentation
Lessons from the consultation EMM remains one of the most complex change projects a health service will undertake Poor project management and unclear communication will deliver a poor implementation EMM is not a set and forget system go live is just the beginning of the journey to delivering those benefits promised in the original business case Begin planning for quality improvement and system optimisation from before go-live to avoid the data tsunami
What comes next? The Commission s work in the area of EMM will produce the following: Updated implementation plan to accompany the Guide and the Requirements Desk top assessment tool Self assessment tool Question sets to interrogate data produced by EMM systems to help health services optimize their implementation
Acknowledgements The Commission would like to the thank the following individuals Steve Saunders, Principal Consultant, Closed Loop & Associates All of the participants in each stage of this project who gave their time, knowledge and comments
Special mention Name Silvia Fazekas Vicki Ibrahim Kate Ebrill Judith Mackson Andrew Hargreaves Louis Cheung Andrew Hugman Rachel Worthington Dr Angus Ritchie Lynn Jamieson A/Prof. Lynette Loy Dr Danielle Stowasser Olimpia Nigro Dr Amanda Walker Prof. Anne Duggan Dr Carolyn Hullick Dr Mike Bainbridge Organisation Prince of Wales Hospital Australian Digital Health Agency Australian Digital Health Agency NSW Ministry of Health ehealth NSW Prince of Wales Hospital Prince of Wales Hospital ehealth NSW Concorde Hospital Peninsula Health Victoria Princess Alexandra - QLD Health QLD Health Sa Health ACSQHC ACSQHC New England Local Health District ASE Health
References 1. Australian Commission on Safety and Quality in Health Care. Electronic medication management systems: a guide to safe implementation, 2nd edition. Sydney: ACSQHC; 2011. 2. Baysari M, Richardson L, Zheng WY, Westbrook J. Implementation of electronic medication management systems in hospitals: a literature scan. Sydney: Australian Commission on Safety and Quality in Health Care; 2016. 3. Australian Commission on Safety and Quality in Health Care. National Safety and Quality Health Service Standards Version 2. Sydney: ACSQHC; 2016. 4. Australian Commission on Safety and Quality in Health Care. NIMC user guide. Sydney: ACSQHC; 2016. 5. Australian Government Department of Health. PBS Hospital Medication Chart [Internet]. Canberra: DoH; 2017 [cited 2017 20 April]. Available from: http://www.health.gov.au/internet/main/publishing.nsf/content/pbs-hmc 6. Australian Commission on Safety and Quality in Health Care. National guidelines for on-screen display of clinical medicines information. Sydney: ACSQHC; 2016. 7. Australian Government Department of Health. National Medicines Policy. Canberra: DoH; 2011. 8. National Health and Hospitals Reform Commission. A healthier future for all Australians: National Health and Hospitals Reform Commission final report. Canberra: Australian Government Department of Health; 2009. http://www.cotasa.org.au/cms_resources/documents/news/nhhrc_report.pdf (accessed Jun 2017).
Herbert Down 02 9126 3583 Herbert.down@safetyandquality.gov.au