Medication management
Role of technology in optimising medication
Gary Mooney discusses the role of technology in driving safety improvements in medication management, as well as the personalisation of therapies through pharmacogenomics.
The prescribing of medications has always presented inherent risks, in part due to the limitations of paper-based systems, requiring handwritten instructions to be communicated in a precise and timely manner. This was perfectly described by Mark Twain when he noted in 1894, “He wrote in a doctor’s hand, which from the beginning of time has been so disastrous to the pharmacist and so profitable to the undertaker”. The ever-evolving sophistication of drug
therapies to treat a broader range of conditions and disease has further exacerbated the potential risks associated with the prescribing of medications. In addition, ageing populations with multiple co-morbidities and numerous concomitant medications present an increased risk profile. For acute care, where most adverse medication events take place, increased patient volumes with reduced resource capacity adds further dimensions for medication errors to occur.
Current digital medication management solutions
While digital medication management solutions have been commonplace in many healthcare services, such as pharmacy and GP practice, for decades, ePrescribing and medication administration (ePMA) solutions have only realistically matured over the last decade. As such they have now reached a position where the complexities of modern acute and tertiary
care services can be comprehensively, safely, and efficiently accommodated as an integral element of broader clinical workflows and the electronic patient record. ePMA solutions have been shown to
reliably improve the efficacy of medication management; workflows, and common risks relating to incorrect prescribing, missed and late doses, and delays in communication across healthcare teams and services. That is where the solution is deployed in an appropriate manner. There are examples to the contrary for sub-optimal deployments. The introduction of complete, legible, and unambiguous digital drug charts that can be accessed flexibly and on-demand, regardless of clinician location, has proven to be the mainstay for the benefits delivered by ePMA solutions. The addition of real-time clinical decision support for prescribers to, for example, alert to medication interactions or patient allergies, has also helped to mitigate a wide range of previously prevalent medication errors.
Although the handwritten chemotherapy Figure 1 – Handwritten chemotherapy script with errors
prescription illustrated by Figure 1 would not, in practical terms, have found a path to patient harm, there are two errors on the form that resulted in wasting the time of pharmacists,
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