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White paper - War against medication errors and creating an error-free medication eco-system v1.2 - ga

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A white paper on medication errors, medication pathway, causes, proposed error-free medication ecosystem leveraging HIPaR BoDK - a wholistic body of drug knowledge platform

A white paper on medication errors, medication pathway, causes, proposed error-free medication ecosystem leveraging HIPaR BoDK - a wholistic body of drug knowledge platform

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  • 1. White Paper War against Medication Errors: Creating an Error-free Medication Eco-systemA white paper on medication errors, medication pathway, causes, proposederror-free medication ecosystem leveraging HIPaR BoDK - a wholistic body ofdrug knowledge platform September 2010 Author Venkateswar Reddy Melachervu Head of Solutions and Technology, HealthNet Global Contributors Dr.Sanjeev Sharma, MD Clinical Pharmacologist, Apollo Health City, Hyderabad Venu Madhav Thirukachi Team Leader, HealthNet Global HealthNet Global Limited Ground Floor | Life Sciences Building | Apollo Health City Campus | Jubilee Hills | Hyderabad 500033| India Phone: +91 40 2355 2322, 4433 4437 | Fax: +91 40 4433 4444 www.healthnet-global.com © All rights reserved.
  • 2. War Against Medication Errors: Body of Drug KnowledgeCopyrightThe information contained herein is provided for the purposes of feedback and evaluation of the concepts touchedupon. The information contained herein is protected, among other things by the Trade Secrets Act, as codified, andany improper use, distribution, or reproduction is specifically prohibited. No license or right of any kind whatsoeveris granted to any third party to use the information contained herein without a written agreement from the Authorand/or his organization. No other use of the information and data contained herein is permitted. Under nocondition should the information contained herein is re-used in any manner whatsoever by any third party withoutfirst receiving the express written permission from the author and/or his organization. © All rights reserved. 2010.White Paper © All rights reserved. 2010
  • 3. War Against Medication Errors: Body of Drug Knowledge“To err is human; To persevere, prevail and prevent the errors is a means beyond humanand towards divinity!” - Unknown to most, known to few “Not by merely abstaining from work can one achieve freedom from reaction! Nor by renunciation alone can one attain perfection!!" - Shrimadhbhagavad Gita, Karma Yoga (Chapter 3), Verse 4White Paper © All rights reserved. 2010
  • 4. War Against Medication Errors: Body of Drug KnowledgeAcknowledgementsSome of the content on medication errors is compiled from various web resources which isused as is. The immediate response of Dr.Sanjeev Sharma on forming some form of clinicalcouncils for my question of how do we achieve credibility and acceptability for the HIPaR BoDKcontent was the genesis for the clinical governance model proposed in this paper.Some of the impactful and visionary phrases used in this white paper (bold italics) are propertyof the author and are being copyrighted.I’d like to express my sincere thanks to Dr.Ranjith Roy Chaudhury, Governing Board Member,Medical Council of India, for his valuable inputs and support for this initiative.My sincere appreciations and thanks are due to Dr.Sanjeev Sharma for his contributionstowards the sections – the current state of HIPaR, Content Sources, Global Benchmarking,Certification and reviewing and providing inputs for the rest of the sections.My sincere appreciations and thanks are due to Venu Madhav for his contributions towards thesections – Global Benchmarking, HIPaR Data Constructs.It’d be unfair on my part if I do not thank for the kind support provided by Shri SreeramaMurthy Seetepalli (father of one of my ex-colleagues Syam Sunder Seetepalli who co-ordinatedthis for me) who authored Visual Bhagawad Gita in guiding me to find an apt verse from one ofthe world’s most ancient Body of Knowledges for human beings – Shri Madhbhagawad Gita-which I read as a child without fully comprehending and appreciating the complete meaning ofwhat I was reading which as the age passes by one feels to find more relevance and tries to findmore comfort in.White Paper © All rights reserved. 2010
  • 5. War Against Medication Errors: Body of Drug Knowledge ContentsAcknowledgements ............................................................................................................... 4Objectives ............................................................................................................................. 7Prologue................................................................................................................................ 7Medication Errors .................................................................................................................. 7Medication Pathway and Points of Failures............................................................................ 8Causes ................................................................................................................................... 9Prevention and Improved Patient Safety.............................................................................. 10HIPaR: Body of Drug Knowledge (BoDK) ............................................................................... 13 HIPaR BoDK Salient Features ........................................................................................... 13 HIPaR BoDK Data Constructs ........................................................................................... 13 HIPaR BoDK Offerings ..................................................................................................... 15 Evolution of HIPaR .......................................................................................................... 16Holistic Clinical Governance ................................................................................................. 17Next Gen Content Administration System ............................................................................ 18Content Sources .................................................................................................................. 22Global Benchmarking .......................................................................................................... 22Certification ........................................................................................................................ 23Vision .................................................................................................................................. 23HIPaR BoDK Applications ..................................................................................................... 24Epilogue .............................................................................................................................. 26About Author ...................................................................................................................... 26White Paper © All rights reserved. 2010
  • 6. War Against Medication Errors: Body of Drug KnowledgeDocument HistoryVersion Date Description0.2 4th Sept 2010 Concept inception and creation of white paper anatomy - Venkateswar Reddy Melachervu0.3 23rd Sept 2010 Content Update – Draft1.0 7th Oct 2010 Completed the first draft contentWhite Paper © All rights reserved. 2010
  • 7. War Against Medication Errors: Body of Drug KnowledgeObjectivesThe objectives of this white paper are:  To understand and analyze the medication errors  Attempt to derive an error-free medication eco-system  Arrive at quintessential role of Body of Drug Knowledge- BoDK  Understand HIPaR BoDK  To define and propose a model for HIPaR BoDK content update and administration that helps tackle medication errors  Clinical Governance Model for HIPaR BoDKPrologue Everyone falls ill sometime rather the other in one’s lifetime and takes medication, if not many times. Medication errors can occur at any point in the medication process and in any care setting. Medication errors can cause long-lasting problems and in the most severe cases, they can result in death. The frequency of medication errors and preventable medication-related injuries represent a very serious cause for concern. Victims of medical mistakes frequently have to endure additional medical attention and as a result, face expensive medical bills that they are responsible for paying because of someone elses errors.Medication ErrorsIn the US alone, 1.5 million Americans are sickened, injured or killed each year by errors inprescribing, dispensing and taking medications of which 7,000 are deaths, annually1. Onaverage, at least one medication error per hospital per patient occurs each day which equals400,000 errors each year, according to IMNA2, USA. The extra medical cost of treating drug-related injuries occurring in hospitals alone, conservatively amounts to $3.5 billion annually3.As defined by a dictionary, error is an act that through ignorance, deficiency, or accidentdeparts from or fails to achieve what should be done. Specifically, medication errors can bedefined as giving the wrong medicine and/or the wrong dose at the wrong time and can be1 st Source : Medication Errors Harming Millions, The Washington Post Report, 21 July 2006,http://www.washingtonpost.com/wp-dyn/content/article/2006/07/20/AR2006072000754.html and stDaily News Central, Health News, Medication Errors Cause 7,000 Deaths per Year, 21 July 2006 -http://health.dailynewscentral.com/content/view/0002352/53/2 Institute of Medicine of the National Academies3 Source: Office of News and Public Information News from the National Academies, National Academy of SciencesMedication errors injure 1.5 million people and cost billions of dollars annually: Jul 2006.http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=11623White Paper © All rights reserved. 2010
  • 8. War Against Medication Errors: Body of Drug Knowledgecategorized into omissions (failure to act correctly) and commissions (acted incorrectly),broadly.The practice of medicine, pharmacy and nursing in a healthcare setting is complicated andinvolves many steps from pen to patient. One study showed that the most common types ofmedication errors were a wrong dose, a wrong drug or a wrong route of administration 4.Medication errors can occur at any point during the medication process—procuring the drug,prescribing, dispensing, administering and monitoring its impact—but occur mostly duringprescribing and administering stages.Medication Pathway and Points of FailuresThe following picture depicts various failures of medication errors at each point of what I defineas Medication Pathway, comprehensively. 5 Figure 1: Medication Pathway and Points of Failures4 Source: Phillips J, Beam S, Brinker A, Holquist C, Honig P, Lee LY,Pamer C. Retrospective analysis of mortalitiesassociated with medication errors. Am J Health Syst Pharm. Oct 2001. 58(19);1835-415 © Copyrighted phrase.White Paper © All rights reserved. 2010
  • 9. War Against Medication Errors: Body of Drug KnowledgeCausesMedication errors may occur more because of contributing factors such as identical doses,dosage forms or routes of administration, similar packaging or labeling, incomplete knowledgeof drugs, illegible handwriting, verbal order errors and even lack of an appropriate knowledgebase, performance and knowledge deficits of the drugs, non-availability of the up-to-dateinformation of the drugs like warnings, precautions etc. It is estimated that confusion regardingdrug is thought to account for 25 per cent of all medication errors. Most of these errors happeneither because of improper or lack of drug information, human errors in medication pathwayetc.One more research report6 shown below depicts various causes for the medication errors. Figure 2: Most Frequently Reported Causes of Medication Errors (Percentage): 7 Voluntary Reporting System 2000-2004The below visual depicts the comprehensive causes for the possible medication failures at eachpoint of Medication Pathway.6 Source : Data - Santell, J.P.et al. 2005. MedMarx Data Report. USP Center for the Advancement of Patient Safety.© 2005 The United States Pharmacopeial Convention Inc. All rights reserved. Failure to act in accordance witheducation and training – McCarthy and Leatherman – Performance Snapshots. 2006 –http://www.cmwf.org/snapshots7 Source : http://www.commonwealthfund.org/Content/Performance-Snapshots/Medication-Mistakes-and-Adverse-Drug-Events/Medication-Mistakes--Types-and-Causes.aspxWhite Paper © All rights reserved. 2010
  • 10. War Against Medication Errors: Body of Drug Knowledge 8 Figure 3: Causes of Medication ErrorsParadoxically, what augments the problem is the absence of a Blame-free Medication Error-Reporting Mechanism in healthcare provider setting that could keep account of errors throughan internal audit process recognizing the fact that human error as an inevitable consequenceand deploying systems in place to minimize consequences of medication errors. The world isyet to witness such an established mechanism for blame-free medication error reporting andmanagement which accounts for the point of having hardly any data on medication errors inhealthcare provider settings, especially for countries like India.Prevention and Improved Patient SafetyEvery health care professional can recall that 9 out of 10 prescription errors are preventable. Inorder to ensure error-free medication procedures, hospitals adopt what is known as 5 Rights:  Right drug  Right dose8 © Copyrighted phrase.White Paper © All rights reserved. 2010
  • 11. War Against Medication Errors: Body of Drug Knowledge  Right route  Right time  Right patientIn spite of 5 Rights being followed diligently, it is observed that in different countries, up to12.9% of hospitalized patients suffer at least one adverse event during their admission out ofwhich 10.8% to 38.7% per cent were caused by medication errors9.There are two more rights that the global medical fraternity has added, of late, to this listmaking it 7 rights:  Right indication  Right documentationNotwithstanding, the world is yet to witness any significant improvement in prevention ofmedication errors.With the increased healthcare awareness, importance, growing concerns on the fatal un-desirable consequences, reducing medication errors and improving patient safety by arrestingor minimizing medication errors has become one of the highest priority areas for the healthcareeco-system players – healthcare providers, pharmacists, doctors, nurses, patients etc.Enhancing patient safety by minimizing or arresting medication error requires a systems-basedapproach in order to control the conditions that contribute towards errors.A little more concentration, a little more discipline, little more process and systems, a littlemore care, a little more faith can save the entire mankind from so many injuries, permanentdamages and deaths caused due to medication errors. After all, the motivation is for a betterhealthcare that leads to beautiful lives.Enhancing the judicious use of medications and minimizing medication errors have always beenkey area for the healthcare fraternity but lacked the necessary systems, platforms, everincreasing up-to-date drug knowledge of tens of thousands of generics and brands and theoptimal automation and integration with Hospital Information Systems along with the requisiteoperational processes for seamless controls of tackling medication errors in the care settings.With the emergence and deployment of pervasive IT systems in the healthcare settings like -HIS, HMS, ePrescription - care providers have embraced the needed systems and platforms thatprovide a base for tackling medication errors which can be supplemented by the manualoperational components enabling a seamless point and click systems that help the care givers inreducing or arresting these errors. Additionally, IT can help build and deploy seamless, blame-free medication error reporting and management systems that are equally important for thisendeavor for the fact that if you cannot measure it; you cannot improve it.109 Source : Quality India - Safe Medication, Safe Healthcare - http://www.qcin.org/nbqp/qualityindia/Vol-3-No1/medical.htm10 Source: Quote of Lord Kelvin, mathematical physicist, engineer and pioneer of thermodynamics.White Paper © All rights reserved. 2010
  • 12. War Against Medication Errors: Body of Drug KnowledgeThe below visual depicts and summarizes the aforementioned concepts and notions in this WarAgainst Medication Errors11. 12 Figure 4: Error Free Medication Eco-systemHowever, what is critically lacking today, is a comprehensive, up-to-date drug knowledgebasethat is quintessential and core of the whole solution for tackling this challenge that embodiesthe ever increasing and changing knowledge and characteristics of the tens of thousands drugmolecules13 for it is increasingly becoming humanly impossible to remember the ever growingbrands, generics and their innumerable number of characteristics that play pivotal role in thiswar against medication errors14 by the healthcare eco-system players. Nonetheless, reducingmedication errors is not a mere onetime activity but an ongoing process of qualityimprovement in the care settings.11 © Copyrighted phrase.12 © Copyrighted phrase and conceptual model.13 It is estimated that there are around 50,000 generic brands and 6,000 generics prevalent in India alone today.These numbers are expected to significantly go up in next 5 years as more generics get added that come out ofpatent regime.14 © Copyrighted phrase.White Paper © All rights reserved. 2010
  • 13. War Against Medication Errors: Body of Drug KnowledgeHIPaR: Body of Drug Knowledge (BoDK)HIPaR BoDK is the Embodiment of Comprehensive Drug Knowledge from HealthNet Globaloffering complete drug related information such as drug - drug interactions, drug-labmodifications, and drug-food interactions, drug-disease interactions, generic search, brandsearch, combination drug search, alternate brands for a given brand/generic, adverse reactions,indications, contra-indications, drug dosages, route of administration, precautions andwarnings, banned drugs, ATC15, retail pricing and packaging information, manufacturers detailsetc.HIPaR BoDK complies with international disease coding standards like ICD-10/9, HL-7,EphMRA16, WHO indications standard etc. that make it easy to integrate with otherclinical/hospital management software, pharmaceutical software or any healthcare software. Itcan also be shared across networks in hospitals, organizations and academic institutions etc.HIPaR BoDK platform is designed keeping with the objective of helping the healthcare fraternityin creating an integrated error-free medication eco-system automating various pharmacy andpharmacological processes, 7 rights frameworks on top of a contemporary Body of DrugKnowledge.HIPaR BoDK Salient Features  Generic search, brand search, combination drug search, alternate brands for a given brand/generic  Indications, contra indications, drug-drug interactions, drug-Lab modifications, drug- food/alcohol interactions  Adverse reactions, precautions and warnings, dosages  Pharmacokinetics, Anatomic Therapeutic and Chemical Classification System - ATC  Mechanism of Action of the drug  Manufacturer search, retail price, packaging details  Information on dose form, route of administration, Strength  Disease classifications, ICD-10 coding  Banned drugs, bar codes, essential drug list, storage conditions etc.  Therapeutic duplication and equivalent  Patient counseling messages  Drug content administration, period updates (role-based user management for security and content quality)  A platform approach that helps the healthcare fraternity in flexibly adapting, integrating for achieving their objectivesHIPaR BoDK Data Constructs15 Anatomic Therapeutic and Chemical Classification System16 European Pharmaceutical Market Research AssociationWhite Paper © All rights reserved. 2010
  • 14. War Against Medication Errors: Body of Drug Knowledge Figure 5: HIPaR BoDK - Generics Data Figure 6: HIPaR BoDK - Brands DataWhite Paper © All rights reserved. 2010
  • 15. War Against Medication Errors: Body of Drug Knowledge Figure 7: HIPaR BoDK - Drug Manufacturer Data Figure 8: HIPaR BoDK Open Data ModelHIPaR BoDK OfferingsWhite Paper © All rights reserved. 2010
  • 16. War Against Medication Errors: Body of Drug Knowledge HIS Integrated HIPaR HIPaR HIPaR Doctor Mobile HIPaR HIPaR Web App SaaS API Mobile Phones Thick client HIS/HMS Custom Built Web Service – J2ME Installs and Thin and thick Drug Supply Integration SOAP Support runs on a PC clients Chain with Portals ePrescription Figure 9: HIPaR BoDK OfferingsEvolution of HIPaRThe product embodies the expertise and experience of almost 10 years of evolution of itscontent and application logic from the group company of Apollo Hospitals founders. Thecontent quantity of HIPaR BoDK as of early 2010 is as below. Parameter Quantity Brands 15000 Generics 4065 Indications 1477 Contra-indications 1229 Adverse reactions 1182 Drug-Drug 669 Dosage Information 1098 Precautions and Warnings 1312 MoA 827 Manufacturers 935The following set of next gen capabilities are the key drivers for the evolution of HIPaR BoDK  Multi-tiered content aggregation, editing, update and administration process enabling logical separation of content activities - editing, review, approve, reject etc.  Constitution of two-tiered clinical governance board - pharmacology and clinical practice – that enables the authenticity, sanctity and control over the content quantity that impacts lives  Updating and releasing the clinical content periodically  Enhancing the characteristics of drugs in the drug knowledgebase – special conditions and dosages, drug-disease, therapeutic duplication information, drug dosages for special conditions like renal failures etc.White Paper © All rights reserved. 2010
  • 17. War Against Medication Errors: Body of Drug Knowledge  Patient counseling messages - drug information to the patient in his language – is lackingHolistic Clinical GovernanceOne of the critical points for an acceptable and credible body of drug knowledge is a clinicallygoverned and enterprise class content administration system. The HIPaR BoDK contentadministration is clinically governed as below:  Clinical governance of the HIPaR BoDK healthcare content by instituting the following councils:  Clinical Pharmacologists Council – council of prominent clinical pharmacologists drawn across Apollo group  Clinical Advisory Council – council of prominent clinical practitioners/medical services directors drawn across Apollo group  Executive Governance Council – council/board comprising of technology, clinical experts and executives that drive the direction of HIPaR BoDK  An enterprise class Next Generation Content Administration system  Multiple content sources aggregation  Multi-tiered  Distinct roles with role-based user management  Auditable and traceable content editing, update, rejection/approval and database administration  A content administration team comprising of bachelor and master pharmacists lead by a clinical pharmacologistThis section focuses on the clinical governance and the next section on the Next GenerationContent Administration system.The below picture summarizes the concepts visually for the holistic clinical governanceaddressing the hitherto identified content sources.White Paper © All rights reserved. 2010
  • 18. War Against Medication Errors: Body of Drug KnowledgeNext Gen Content Administration SystemThe core to the design of the Content Administration System is the fundamental concept ofmulti-tiered, role-based, and clinically governed Content Update Process that we’ve uniquelydeveloped for this purpose considering the need to ensure the sanctity of the data that impactsthe lives of the human beings and the focus on the India specific content. The following picturedepicts the multi-tiered content update process that incorporates the Holistic ClinicalGovernance addressed in the previous section.White Paper © All rights reserved. 2010
  • 19. War Against Medication Errors: Body of Drug Knowledge Figure 10: Next Generation Clinical Content Administration PlatformWe at HealthNet Global have analysed, understood, recognized and built a tiered, role-based,auditable enterprise class content management system as an integral part of Next GenerationHIPaR BoDK platform and have instituted content development team (pharmacists, clinicalpharmacologists etc.) and experienced software development team which have developed anddeployed an enterprise class Content Administration System for HIPaR BoDK where a specialteam of pharmacists (B.Pharms and M.Pharms) lead by a senior clinical pharmacologist areediting and updating the content aggregating the clinical content from various popular andcredible sources to it one of the world’s leading BoDK for India and beyond.The BoDK Content Administrator offers drug content sources aggregation, content entry,content review, content approval, audit information, content publishing using Internetleveraging cloud technologies, role-based secured user management and databaseadministration etc. enabling a robust anytime and anywhere secured system. Some of thescreen captures of BoDK Content Administrator are shown below.White Paper © All rights reserved. 2010
  • 20. War Against Medication Errors: Body of Drug Knowledge Figure 11: HIPaR BoDK Content Administrator Role-based Login Figure 12: HIPaR BoDK Content Administrator Auto Suggest of Brands, Generics etc.White Paper © All rights reserved. 2010
  • 21. War Against Medication Errors: Body of Drug Knowledge Figure 13: Content Administrator - Generic edit Screen Figure 14: Content Approver LoginWhite Paper © All rights reserved. 2010
  • 22. War Against Medication Errors: Body of Drug Knowledge Figure 15: Content Administrator - Approver ScreenContent SourcesThe following are the content sources used hitherto for cleansing and updating the existingcontent:  Pharmaceutical Manufacturer Product Monographs  Indian Pharmacopoeia Version 2010  Wolters Kluwer’s Drugs in Pregnancy & Lactation Version  Central Drugs Standard Control Organization website  http://cdsco.nic.in/  Australian Registry of Therapeutic Goods and Medicines - https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/PICMI?OpenForm&t=PI &k=0&r=/  Health Canada website  http://webprod.hc-sc.gc.ca/dpd-bdpp/start-debuter.do?lang=eng  New Zealand Medicines and Medical Devices Safety Authority Website  http://www.medsafe.govt.nz/  US FDA website  http://www.fda.gov/Global BenchmarkingWe’ve benchmarked HIPaR BoDK platform clinical fields/capabilities and content with some ofthe national and international products used for the similar purposes and summarized below.The benchmarking focus was more on the clinical fields/capabilities as the clear data on thequantity of the content of these products is hardly available. Clearly HIPaR BoDK stands out andon top with its longer list of supported capabilities.White Paper © All rights reserved. 2010
  • 23. War Against Medication Errors: Body of Drug Knowledge Figure 16: HIPaR BoDK Global BenchmarkingCertificationAcceptability and credibility of the content is critical to the core of HIPaR BoDK given its impacton human lives. This typically, comes with accreditation/certification by renowned institutionsand organizations globally that are independent and have acclaimed expertise in the relevantsubject matter. In our research, we are yet to find such a straight body that certifies drugknowledge or drug database.We are in the process of identifying and pursuing the certification with organizations that haverelevance to pharmacy and pharmacology.VisionTransform HIPaR into next generation ubiquitous body of drug knowledge platform that playsa pivotal and core role in the prevention of medication errors, integrated medicinemanagement throughout the medication pathway empowering healthcare fraternity with aWhite Paper © All rights reserved. 2010
  • 24. War Against Medication Errors: Body of Drug Knowledgecomprehensive, ever up-to-date, seamless, credible body of drug knowledge at a touch of abutton that endeavors to create an error-free medication eco-systemHIPaR BoDK Applications Generic based Drug Inventory control using HIPaR BoDK helpsEfficient Drug Inventory Management achieve efficient control on stock refills. HIPaR BoDK helps the Pharmacist conduct a prescription auditPrescription Audit providing indications for the prescribed drugs in Hospital HIPaR BoDK can be used as education and drug awareness by theDrug Education for Patients patients HIPaR BoDK helps drug regulators to avoid Look Alike, Spell AlikeEfficient Drug Licensing and Sound Alike drugs while licensing HIPaR BoDK enables nurses for educating the Patients on DrugsDrug Education for Nurses and monitoring Patients on drug therapy HIPaR BoDK helps students with a comprehensive drugDrug Education for Medical Students knowledge base HIPaR BoDK enables Pharmacist and Doctors find a BrandBrand Equivalent Equivalent of a Drug HIPaR BoDK helps patients conveniently identify a Drug forConvenient drug identification by patients consumption based on the Color/Image? HIPaR BoDK enables healthcare providers especially public healthGeneric Based Prescription care providers in implementing a generic based prescribing in place of brand based prescribing HIPaR BoDK enables Insurance Providers to Validate theClaims Validation Insurance Claims related to Drugs - Age, Gender, and Disease HIPaR BoDK enables doctors to adjust drug dosage for patientsDrug Dosage adjustments for Renal Failure with renal failure. HIPaR BoDK enables doctors to adjust drug dosage for patientsDrug Dosage adjustments for Hepatic Failure with hepatic failure. HIPaR BoDK can alert the doctors about the contraindications ofContra Indications the drug they are prescribing enhancing the Patient Safety HIPaR BoDK enables Health Care Providers in preventing dosageDosage Error Prevention errorsPrevention of Drug Errors in Pregnancy HIPaR BoDK enables Health Care Providers/Doctors in preventing/Lactating Women Drug Errors for Pregnancy/Lactating Women HIPaR BoDK enables dietitians in creating a customized dietaryCustomized Dietary Plan for Chronic Patients plan for Patients on Pharmacotherapy in case of chronic conditions HIPaR BoDK enables doctors in preventing therapeuticPrevention of Therapeutic Duplication duplication of the drugs HIPaR BoDK enables health care providers in institutionalizingInstitutionalized Body of Drug Knowledge drug knowledge across the organization sans boundaries HIPaR BoDK enables healthcare providers, pharmaceuticalFind Manufacturer of a brand companies, regulators to find manufacturers for a given generic/brandWhite Paper © All rights reserved. 2010
  • 25. War Against Medication Errors: Body of Drug Knowledge HIPaR BoDK can act as a reference tool for financial decisions byPrice reference for Drug Purchases healthcare providers, pharmacies, insurance providers and patients HIPaR BoDK enables doctors, pharmacists, pharmacologists for identifying drug - drug interactions and taking necessary actionsDrug-drug interactions for enhanced patient safety. Helps medical students, pharmacists in learning. HIPaR BoDK enables biochemists, micro biologists and doctors inDrug-lab interactions right interpretation of lab results avoiding unnecessary or wrong treatment. HIPaR BoDK enables dietitians and doctors plan a customizedDrug-food interactions dietary for a patient for the better management of a disease avoiding treatment failure and adverse effect. HIPaR BoDK enables anesthetists to plan anesthesia for patientDrug-anesthesia interactions on drug therapy avoiding mishaps during the anesthesia. HIPaR BoDK enables doctors to warn the patients regarding theDrug-Alcohol interactions alcohol consumption for mishaps while patient is on drug therapy. HIPaR BoDK enables doctors in assessing the risk benefit ratio toPrecautions, warnings prescribe drugs to special category cases(Pregnancy, Lactation, Pediatric and Geriatric etc..) HIPaR BoDK enables researchers and medical students inPharmacokinetics analyzing and understanding Pharmacokinetic profile of drugs. HIPaR BoDK enables researchers for doing drug utilization studiesATC information and DDD and better inventory planning control HIPaR BoDK enables medical students in learning about thePharmacological category and sub-category pharmacological classification system and helps the pharmacistinformation in identifying therauptic substitutes. HIPaR BoDK enables Hospital nursing staff in properNursing considerations reconstitution, storage, administration and monitoring the patient on drug therapy. HIPaR BoDK provides unique opportunity in India for regulatory agencies, Manufacturers, Insurance providers, health careHIPaR Unique Article Code providers etc. To uniquely and unambiguously address the health care item across the systems. HIPaR BoDK provides the ICD10 Disease code information for anyICD-10 Information given disease and vice versa. HIPaR BoDK enables medical students and doctors in learningDrug Search by Disease drug therapy for various diseases. HIPaR BoDK enables doctors and patients in knowing and tacklingDrug Side Effects the side effects while drug therapy. HIPaR BoDK enables patients and pharmacists to identifyOTC information of a drug whether a drug is OTC drug or not. HIPaR BoDK enables doctors and pharmacists to identify theGeneric Synonyms global generic synonym. HIPaR BoDK enables doctors, regulators, pharmacists, nurses andLook Alike, Sound Alike and Spell Alike Drugs patients in preventing the medical errors and enhancing patientInformation safety.White Paper © All rights reserved. 2010
  • 26. War Against Medication Errors: Body of Drug Knowledge Drug Packaging - bulk packaging and HIPaR BoDK enables pharmacy and health care providers in retail/selling packaging information maintaining the better inventory management. HIPaR BoDK Platform helps the healthcare providers and regulators in automating the process and deploying the system Integrated Pharmaco-vigilance online for seamless easy-to-use access for pharmaco-vigilance in reporting and verifying the adverse effects along with periodic reportsEpilogueAs per a latest article in a medical journal17 (2008), the medical errors kill anywhere between48,000 – 80,000 Americans annually and the article claims majority part is due to MedicationErrors. Imagine saving a fraction percentage of these lives by creating an error-free medicationeco-system which can still run into saving tens of lives annually which is more than the meaningfor our endeavor of War Against Medication Errors and we firmly of the view that thistransformation should pick up the momentum now and should not stop at saving mere tens oflives.We humbly appeal to the healthcare fraternity through this white paper to come forward for acollaborative endeavor, join hands with us for an inclusive effort to wage and win the WarAgainst Medication Errors18.Together, let us march forward and work towards ushering in an Error-free Medication Eco-system19 leveraging the comprehensive Body of Drug Knowledge, first in the IP care setting andthen beyond IP care setting in the journey of Touching Lives.About AuthorVenkateswar Reddy MelachervuVenkat is a well-rounded professional with technology expertise, business acumen and proventimely results in conceiving profitable ideas and transforming these profitable ideas intoproducts and solutions across multiple domains leveraging cutting-edge technologies usheringpositive impacts to the top lines and bottom lines – start-ups or grown-ups, locally or globally.Venkat is the member of the founding team of HealthNet Global and currently associate vicepresident and head of technology and solutions. In this role, he heads technology and solutionsand is responsible for company’s solutions, services, technology strategy, roadmap and conceptselling to - enterprises, governments, partners and investors.Venkat earned bachelors degree in electronics and communications engineering withdistinction where he was first exposed to the nature and significance of electronics,17 Source : Clinical Review: Medication Errors in Critical Care: Critical Care 200818 © Copyrighted phrase.19 © Copyrighted phrase.White Paper © All rights reserved. 2010
  • 27. War Against Medication Errors: Body of Drug Knowledgetelecommunications and information technology convergence and the power there-of, whiledeveloping hardware, software and firmware for his final year project Digital Filters UtilizingMicroprocessors on Intel 8085. This work has significantly influenced his professional journey hehas embarked there on.He believes in technology in isolation has no meaning neither to business nor to humans unlessseen in a problem solving or value creation context, dares to dream, cares to win and workstowards transforming the lives through technology. More details can be found about him onLinkedin.------------------------------------------------ End of White Paper----------------------------------------------------White Paper © All rights reserved. 2010