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iSoft MedChart Evaluation

An evaluation of iSoft's MedChart ePrescribing system
by

Hayley Rickett

on 23 July 2013

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Transcript of iSoft MedChart Evaluation

ePrescribing
replaces paper based prescription processes
iSoft MedChart
access patient records | update prescription information
system checks patient history | displays important information
prescription is authorised by clinician
prescription sent to pharmacy to be filled
Medication errors: the most common type of medical error in healthcare
- Institute of Medicine, 2000
1. Medication management
2. Referencing
3. Decision support
4. Offline backup
5. Reporting
6. Technology
1. Medication management
2. Referencing
3. Decision support
4. Offline backup
5. Reporting
6. Technology
Domain
Mechanism
Timing
Defining a Framework for Health Information Technology Evaluation
(Eisenstein, E. L, Juswishin, D., Kushniruk, A., & Nahm, M., 2011)
After implementation
Medication management
Decision support
Efficacy of implementation:
adoption
uptake
use
outcomes (error rates)
Effects of Two Commercial Electronic Prescribing
Systems on Prescribing Error Rates in Hospital In-Patients: A Before and After Study
(Westbrook et al, 2012)
60%
reduction in
error rates
44%
rate of serious errors
35% of errors
system related
Study Conclusions
implementation reduced prescribing errors
decision support system limited
lack of reduction in clinical errors
high rate of system-related errors
more studies needed, but overall findings evidence in favour of ePrescribing systems
The Effectiveness of an Electronic Medication Management System to Reduce Prescribing Errors in Hospital
(Westbrook et al, 2010)
22.5
9.0
prescribing errors
per 100 patient days
2.14
1.75
severity of errors
(5 point scale)
Incomplete and unclear orders eliminated
Ordering decisions unchanged
Study Conclusions
effective at reducing prescribing errors related to documentation
limited decision support system caused prescribing error rates (ordering decisions) to remain unchanged
Implementing electronic medication management at an Australian teaching hospital
(Day et al, 2011)
Concerns:
increased workload
lack of resources
lack of significant outcomes
Positives
Negatives
clearer charts
reduction in pharmacy interventions
decision support
flow on effect to best-practice
team work
work practice changes
too many clicks
training
lack of after-hours support
previous medication list reviews
before & after
no time differences in
prescribing
dispensing
locating
100%
38%
MedChart beneficial to patient care
12
19
(very) dissatisfied
Study Conclusions
system can be beneficial
biggest challenge: attitudes of clinicians
implementation ultimately successful
Evaluation Conclusions
MedChart has a significant impact on prescription management error rates
Limitations:
change management
training costs - money/time
decision support
Promising signs of being effective overall
Improvement needed before becoming commonplace
Evaluation by Hayley Rickett
Full transcript