Take one Palliative Care Data Standard, a
course of NZ Universal List of Medicines, the
New Zealand Formulary and the NZeP...
Overview of presentation
• Introduction
• End Users Overview (Megan)
– Palliative Care Dataset
– Prescribing Solution

• I...
Introduction
• Common themes
– Output requirements were specified
– Input and workflow had to be determined
collaborativel...
Our Region
Palliative Care Data Definitions
Standard
HISO 10039.1 and HISO 10039.2
•Provides a basis of a common language for
recordi...
Data Issues
Pre Implementation
•
•
•
•
•
•

Multiple data entry screens
No definitions for fields
Non compulsory data entr...
Implementation
•
•
•
•
•

Resourcing
Change Management
Communication
Education of users
Challenges to work flow and
busine...
End User Recommendations
• Scope the project well.
• Strong working relationship with vendor and
external stakeholders.
• ...
Prescribing information workflow and
objectives
Workflow
• Prescription Creation
– Medication selection
– Interaction chec...
Solution Components
NZF
NZULM

Houston Medical
VIP.net

Patient Health Information
Management System
(Hospice)

NZePS

Dis...
Clinician Requirements
• Doses: A list of doses associated with each medicine. Doses should
be easy to maintain.
• Medicat...
Prescribing Functionality Evaluation
•
•
•
•

NZF interaction checking is working well
Improved prescription generation
Pr...
Implementer Challenges
• Relationship Management: Huge overhead when piloting
• Challenge of justifying benefits: Having t...
Community ePrescribing
Recommendations
• More work is needed to understand the
potential impact to clinician’s workflow wh...
Lessons Learned
• Scope everything thoroughly
• Set realistic timeframes and adequately
resource the project
• Understand ...
The importance of recognition –
What an achievement!
Thanks to:
Arohanui Clinicians
Houston Medical
Developers
Patients Fi...
Questions
Take one Palliative Care Data Standard, a course of NZ Universal List of Medicines, the New Zealand Formulary and the NZeP...
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Take one Palliative Care Data Standard, a course of NZ Universal List of Medicines, the New Zealand Formulary and the NZePS. Avoid allergies: Integrate well!

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Presented by Corrine Gower
Victoria University of Wellington

Megan Peterson
Arohanui Hospice

Published in: Health & Medicine, Business
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Take one Palliative Care Data Standard, a course of NZ Universal List of Medicines, the New Zealand Formulary and the NZePS. Avoid allergies: Integrate well!

  1. 1. Take one Palliative Care Data Standard, a course of NZ Universal List of Medicines, the New Zealand Formulary and the NZePS. Avoid allergies: Integrate well! Corinne Gower Victoria University of Wellington and Houston Medical Megan Peterson Arohanui Hospice, Palmerston North HINZ Presentation, Thursday 28th November 2013
  2. 2. Overview of presentation • Introduction • End Users Overview (Megan) – Palliative Care Dataset – Prescribing Solution • Implementers Overview (Corinne) – Palliative Care Dataset – Prescribing Solution • Lessons Learned • Questions
  3. 3. Introduction • Common themes – Output requirements were specified – Input and workflow had to be determined collaboratively. • Points of difference – Palliative Care DS: Design and development phase was the major phase. No third party product integration. – Prescribing: UAT phase was the major phase. Extensive third party product integration.
  4. 4. Our Region
  5. 5. Palliative Care Data Definitions Standard HISO 10039.1 and HISO 10039.2 •Provides a basis of a common language for recording information about service contacts that can be shared and compared between stakeholders, and for understanding palliative care in NZ.
  6. 6. Data Issues Pre Implementation • • • • • • Multiple data entry screens No definitions for fields Non compulsory data entry Lack of user understanding Incomplete and inconsistent data output Data could not be relied upon
  7. 7. Implementation • • • • • Resourcing Change Management Communication Education of users Challenges to work flow and business processes
  8. 8. End User Recommendations • Scope the project well. • Strong working relationship with vendor and external stakeholders. • Determine impact on end to end business processes (eg. referral management). • Education sessions should including context and constant reviewing of the data. (Take with wine, repeat as required!)
  9. 9. Prescribing information workflow and objectives Workflow • Prescription Creation – Medication selection – Interaction checking – allergies and drug-drug interaction – Regular Medication recording • Output – paper and electronic – Correspondence – information sharing • Incoming dispensing messages. Objectives • Reduce preventable medication errors • Facilitate greater use of generic (non-trade/brand) drugs.
  10. 10. Solution Components NZF NZULM Houston Medical VIP.net Patient Health Information Management System (Hospice) NZePS Dispensing System (Pharmacy)
  11. 11. Clinician Requirements • Doses: A list of doses associated with each medicine. Doses should be easy to maintain. • Medication readability: – ‘paracetamol 500mg tablet’ – ‘paracet 500mg+pseudoeph HCl 30mg (&) chlorpheniramine mal 2mg+paracetamol 500mg+pseudoeph 30mg tabs’, • Secondary use of prescribing information in correspondence • Drug Allergy alerts: Recognition of existing drug allergy alerts • Form/Strength: Option to prescribe either by form (1 tablets, 5 ml) or by strength (10 mg). – A pick list of administrative units is confined to units associated with the medication in the NZULM. • Supply: Need to request pharmacist to determine supply quantity. – Administration Unit of ‘QS’
  12. 12. Prescribing Functionality Evaluation • • • • NZF interaction checking is working well Improved prescription generation Prescribing data now makes greater clinical sense Fewer scripts returned or queried by the pharmacy because supply details have been overlooked • Some optional fields, such as medication route, are being omitted because they do not read well on the prescription. • Increased generic prescribing – System default and generic/trade cross matching • No improvements in dose consistency – Latin/non-Latin frequency and timing instructions.
  13. 13. Implementer Challenges • Relationship Management: Huge overhead when piloting • Challenge of justifying benefits: Having to sell government strategy, Connected Health licenses. Documents and implementation specifications have limited value in communicating change drivers and benefits directly to information system end users. • Technical Complexity: Huge. With integration to third party products you have to know where the boundaries are. Medicines are included in the NZULM that are not yet available. • Collaboration: Need for regular site visits • Expectations: Structured data entry is extremely difficult.
  14. 14. Community ePrescribing Recommendations • More work is needed to understand the potential impact to clinician’s workflow when a standard or specifications are developed. • Need to ensure there is a clear path to convert data (such as allergies) from old to new system. • Useful to have supporting documentation or web based information, such as case studies, to support implementation.
  15. 15. Lessons Learned • Scope everything thoroughly • Set realistic timeframes and adequately resource the project • Understand clinician workflow • Engage clinicians, nurses and allied staff • The perfect system does not exist
  16. 16. The importance of recognition – What an achievement! Thanks to: Arohanui Clinicians Houston Medical Developers Patients First Team (Peter Jordan) NZULM (Craig Mabon) NZF (Chris Hilder)
  17. 17. Questions

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