Intersector communication of medication information
It is the objective of this model project to improve the pharmacotherapy safety by intersectoral networking and communication of medication data. To achieve this, more than 20 practises are electronically connected and bound to the information system of the central emergency room of the Fürth hospital centre.
For the first time, this extensive networking enables registered and hospital doctors comprehensive transfer of medication data and a validation of the prescribed drugs for tolerance. Due to the digital data exchange format, electronic knowledge databases and decision support systems can be used. The ad-hoc utilization of databases is necessary, because in Germany approximately 10,000 drugs are approved for the healthcare market and no doctor is in a position to remain up-to-date with comprehensive knowledge. The captured results are continuously input into a knowledge database, where they are evaluated and analysed further using scientific data.
A back channel is provided to enable registered doctors to receive medication data in a timely and complete manner upon release of the patient from the hospital. The additional option to exchange medication data even within the registered sector is provided to investigate whether the number of medication-related hospitalisations are reduced by the common utilization of an electronic medication plan.
This means that for the first time permanent electronic transfer of medication data is enabled across fields and sectors with a large representative patient population. The tasks included in this project are not only used to measure the influence of an improved data collection on the problems connected with the undesired side effects and medication errors, but also their early detection. Moreover, the digital medication plan allows for a transparent summary of the intended usage of the medication. It enables you to determine at a glance whether the present medication is in line with established scientific insights.
Towards the end of the project duration, evidence of the following improvements should be present:
- Reduction of non-indexed drugs >15 %
- Reduction of multiple medication > 15 %
- Reduction of number medication errors > 15 %
- Improvement of the detection of undesired side effects upon hospital entry > 10 %
- Reduction of the duration of the drug anamnesis upon entering the hospital > 50 %
The professorship for clinical pharmacology and HellmannConsult perform constant audits regarding the suitability of the medication plan for drug therapeutical security. As the conclusion, feedback is given to the drug commission of the German doctor's association to allow for the creation of a practicable medication plan.
Undesired side effects are recognized as one of the most common causes of death. In Germany, hundreds of thousands of patients are transferred to a hospital due to severe undesired side effects. Particularly affected are elderly patients who take many drugs due to multiple diseases or patients who consume dangerous combinations of drugs in attempts at self-medication.
Due to the pharmacological characteristics, more than half of these effects should be predictable and 30 % should be avoidable under clinical aspects.
The reasons for the frequent occurrence of undesired medical events include lack of knowledge about the following:
- existing prescribed medication and the indication for the prescription
- potential undesired medical events of prescribed drugs
- potential interactions with other drugs
This lack of knowledge is caused by missing standards for the processes used to transmit medication information between the doctors in charge. In most cases, the transmitters of information are the patients who are rarely capable of transmitting accurate medication and treatment details. This way, none of the doctors in charge has access to the complete picture of the patient's medication.
Comprehensive knowledge regarding the medication therapy of the patient requiring treatment is the base requirement for the planning of a safe therapy, not just in a sense of therapeutical success, but also in view of avoiding undesired side effects or medication errors. Measures aimed at risk reduction and optimisation of drug therapy safety are a definite requirement.
Within the scope of intersectoral collaboration between the medical practices of the doctors' association in Middle Franconia and Fürth hospital, Astrum-IT provides a connection platform for the partners. Medication data and patient master data containing diagnoses indicating the drug therapy are transmitted via this platform The scope of information that results at a higher level has the following consequences
- coordinating the prescription process within the cooperation
- increasing the detection rate of drug-related danger situations such as undesired side effects or medication errors.
- reducing non-indicated or counter-indicated drugs
- verifying the specification of the medication plan as the basis for electronic drug therapy safety
The evidence for better treatment via theses measures and a continuing and process-related consultation and evaluation of the results is provided by the professorship for clinical pharmacology of the Erlangen university hospital and HellmannConsult.
01.05.2013 - 28.02.2015
ASTRUM IT GmbH
Am Wolfsmantel 2