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Electronic Medication Management Systems A Guide to Safe Implementation Edition ND 2

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  • Electronic Medication Management Systems A Guide to Safe Implementation

    EditionND2

  • Electronic Medication Management Systems

    A Guide to Safe Implementation

    2nd Edition

  • Electronic Medication Management Systems A Guide to Safe Implementation, 2ndedition, 2012.

    ISBN Print: 978-1-021983-19-1

    ISBN Online: 978-1-921983-20-7

    Commonwealth of Australia 2012

    This work is copyright. It may be reproduced in whole or in part for study or training purposes subject to the inclusion of an acknowledgement of the source. Requests and inquiries concerning reproduction and rights for purposes other than those indicated above requires the written permission of the Australian Commission on Safety and Quality in Health Care, GPO Box 5480 Sydney NSW 2001 or [email protected].

    Suggested citation: Australian Commission on Safety and Quality in Health Care. Electronic Medication Management Systems A Guide to Safe Implementation, 2nd edition, ACSQHC, Sydney, 2012.

    Acknowledgements: The Australian Commission on Safety and Quality in Health Care (ACSQHC) wishes to acknowledge the contribution of participating clinicians and organisations in the development and review of this guide. The first edition of this guide was developed by KPMG in conjunction with Trilogy Information Solutions. The principal author of the second edition was Steve Saunders of Trilogy Information Solutions and the principal reviewer was Katrina Richardson of St Vincents Hospital. To provide feedback on this guide, please contact ACSQHC.

    This document can be downloaded from the ACSQHC web site: www.safetyandquality.gov.au

    ACSQHC can be contacted at: Australian Commission on Safety and Quality in Health Care GPO Box 5480 Sydney NSW 2001

    Tel: 02 9263 3633 Fax: 02 9263 3613 Email: [email protected]

    If calling from overseas: Tel: +61 2 9263 3633 Fax: +61 2 9263 3613

    Edited and produced by Biotext, Canberra

    mailto:[email protected]://www.safetyandquality.gov.aumailto:[email protected]

  • iii

    Contents

    Preface .......................................................................................................................................................... ix

    Acronyms and abbreviations ................................................................................................................ xi

    1 Overview .......................................................................................................................................... 1

    1.1 Purpose .......................................................................................................................................11.2 Scope ..........................................................................................................................................11.3 Exclusions ..................................................................................................................................21.4 Additions ....................................................................................................................................3

    2 How to use this guide ................................................................................................................ 5

    2.1 Clinicians ...................................................................................................................................62.2 Private hospitals ......................................................................................................................62.3 Australian Governmentfunded programs .......................................................................62.4 Members of EMM governance ............................................................................................62.5 Information and communications technology personnel ............................................7

    Section A EMM system context and requirements .................................................................... 9

    3 The case for change .................................................................................................................11

    4 Essential elements for EMM implementation ................................................................13

    5 The medication management continuum .........................................................................15

    5.1 The inpatient medication management process ......................................................... 15

    6 The EMM strategic and business contexts ....................................................................21

    6.1 The strategic context .......................................................................................................... 216.2 The business context ........................................................................................................... 23

    7 EMM and the Pharmaceutical Benefits Scheme ..........................................................25

    7.1 PBS prescriptions in public hospital outpatient settings .......................................... 267.2 PBS prescriptions for public hospital discharges ........................................................ 267.3 PBS access in private hospitals ........................................................................................ 28

    8 EMM and the National Medication Work Program ....................................................29

    8.1 Electronic transfer of prescriptions ................................................................................. 298.2 The Personally Controlled Electronic Health Records program ............................... 308.3 The Australian Medicines Terminology .......................................................................... 308.4 Implications for EMM systems ......................................................................................... 31

    9 Functional and technical specifications for EMM systems ......................................33

    9.1 Prioritising EMM functional and technical components .......................................... 339.1.1 Core features ........................................................................................................................... 349.1.2 Desirable features .................................................................................................................. 349.1.3 Aspirational features ............................................................................................................ 34

    9.2 Functional components ...................................................................................................... 35Functional component 1.0: General ................................................................................................ 38

  • iv Electronic Medication Management Systems A Guide to Safe Implementation

    Functional component 2.0: Medication orders ............................................................................ 45Functional component 3.0: Clinical decision support ................................................................ 50Functional component 4.0: Pharmacy review............................................................................... 55Functional component 5.0: Medication dispensing .................................................................... 57Functional component 6.0: Medication administration ............................................................ 57

    9.3 Technical components software .................................................................................. 63Technical component 8.0: Standards and terminology .............................................................. 64Technical component 9.0: e-health interoperability .................................................................. 67Technical component 10.0: Support system integration ........................................................... 69

    9.4 Technical components hardware................................................................................. 70Technical component 11.0: Infrastructure ......................................................................................71Technical component 12.0: Devices ................................................................................................. 72

    9.5 Technical components business continuity management ................................... 75Technical component 13.0: Business continuity .......................................................................... 76

    Section B EMM organisational considerations ..........................................................................79

    10 Principal stakeholders and key users................................................................................81

    10.1 Principal stakeholders and decision makers ................................................................. 8110.1.1 Chief executive officer ..........................................................................................................8110.1.2 Director of medical services / medical superintendent / medical ...............................

    champions ................................................................................................................................ 8210.1.3 Director of pharmacy ............................................................................................................ 8310.1.4 Director of nursing and midwifery.................................................................................... 8410.1.5 Chief information officer ..................................................................................................... 8510.1.6 Drug and therapeutics committee


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