Standardising Medicines Data
in Public Hospitals
The Obstacles & Opportunities
12th September 2013
PresentationOverview
Hospital pharmacy systems in NSW
Opportunities & Obstacles
Project approach
Support model
Future oppo...
Project Background
Landscape – 2010
90 Hospital Pharmacy Departments
32 databases
21 pharmacy product files
2 pharmacy app...
HPPL Approach
Medication Safety
Consistent medicines reference information available to
patients and staff across all NSW ...
HPPL Approach
Operational
Reduced i.Pharmacy product file maintenance across NSW
Electronic product request management pro...
HPPL Approach
Area Health Service > Local Health District switch
Stakeholder Engagement
– Scepticism from some about a sta...
HPPL Approach
The Hospital Pharmacy Product List (HPPL) was the title
given to the single product file which would be used...
Reconcile Prescribe Order Dispense Administer
WhatisintheHPPL?
The HPPL is the single list of pharmaceutical products that...
DevelopmentApproach
Editorial
Guidelines
Build
Stakeholder
Review
Define editorial
guidelines for all
hospital
pharmacy
pr...
ImplementationApproach
Engage
Data
Cleansing
Data Mapping and Validation
UAT
1
ELS
Organisation Change Management Support
...
ImplementationProgress
New South Wales
Metropolitan
= in progress
(complete by Dec 2013)
= complete (over half the State)
Requests for new products are submitted electronically
through the Product Request Tool. Data alignment with
terminology s...
Managingmultipleversions Multi-version Target State
FutureOpportunities
HPPL
NSW Master
Drug Catalogue
Pharmacy Data
Warehouse
Reconciliation
Prescribing
Procurement
Dispensi...
NSWMasterDrugCatalogue
Summary
Achievements
Terminology standards implemented + supported
Efficient product request management process
State-wide...
Questions
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Guy Player standardising medicines data in public hospitals

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Guy Player delivered the presentation at the 2013 eHealth Interoperability Conference.

The 2013 eHealth Interoperability Conference program is a balance between updates on state-wide interoperability projects, health service eHealth project case studies, and discussions of overarching principles such as information governance, data standardisation, and the future direction of eHealth in Australasia.

For more information about the event, please visit: http://www.informa.com.au/eHealth13

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Guy Player standardising medicines data in public hospitals

  1. 1. Standardising Medicines Data in Public Hospitals The Obstacles & Opportunities 12th September 2013
  2. 2. PresentationOverview Hospital pharmacy systems in NSW Opportunities & Obstacles Project approach Support model Future opportunities
  3. 3. Project Background Landscape – 2010 90 Hospital Pharmacy Departments 32 databases 21 pharmacy product files 2 pharmacy applications 2 database management systems 3 versions of i.Pharmacy Project Scope Standardise technology Consolidate i.Pharmacy databases Standardise medicines data NSWHospitalPharmacySystems
  4. 4. HPPL Approach Medication Safety Consistent medicines reference information available to patients and staff across all NSW public hospitals via i.Pharmacy Regular updates of drug interaction data “One stop-shop” for medication safety initiatives: – Child resistant caps warning labels – Tall Man lettering – Barcode scanning Provides the foundation for: – future integration of i.Pharmacy with electronic prescribing systems – developing common i.Pharmacy practice across the state – defining other state level data sets (e.g. Interventions, sig codes) Opportunities
  5. 5. HPPL Approach Operational Reduced i.Pharmacy product file maintenance across NSW Electronic product request management process Products added to system within hours Specialised central group managing state-wide datasets ensuring standards are maintained across the state Streamlined implementations of State contract variations Support for barcode scanning during dispensing Foundation for ‘pharmacy data warehouse’ to provide an efficient state level reporting capability for: – Spend analysis for contract management – Drug usage reporting (e.g. Antibiotics) – Activity Based Funding Opportunities
  6. 6. HPPL Approach Area Health Service > Local Health District switch Stakeholder Engagement – Scepticism from some about a state program of this nature – Unclear benefits – No project mandate Impact of the HPPL on pharmacy departments – No flexibility to manage product data locally – New terminology (e.g. generic names, forms, UOMs) – Changes to other i.Pharmacy attributes (e.g. account codes) – i.Pharmacy for medicines only (i.e. not everything used in a pharmacy) – Standadising data resulted in some process standardisation (e.g. aseptic manufacturing) – Loss of transaction history – Reporting across new and archive databases Governance Obstacles
  7. 7. HPPL Approach The Hospital Pharmacy Product List (HPPL) was the title given to the single product file which would be used in i.Pharmacy across NSW public hospitals. Options: 1. Australian Medicines Terminology (AMT) * 2. i.Pharmacy product file from within NSW 3. i.Pharmacy product file from another State 4. Define terminology guidelines and build a data set which would be mapped to the AMT *The AMT could not be used natively in i.Pharmacy v5.6 because: – i.Pharmacy field size limitations – Some AMT descriptors were not ‘user friendly’ – Descriptions had to be printable on dispensing labels – AMT does not include all hospital pharmacy products: • Clinical trials • Locally manufactured products (e.g. aseptic, cytotoxic, TPN, extemp.) • Repackaged HPPLApproach
  8. 8. Reconcile Prescribe Order Dispense Administer WhatisintheHPPL? The HPPL is the single list of pharmaceutical products that will be used by hospital pharmacies across NSW. Products descriptions are based on the Australian Medicines Terminology and products are configured to support pharmacy good practices (e.g. drug interaction checking and barcode scanning). Consistent identification of contract items (902 Pharmaceutical Contract) Consistent medicines terminology for all hospital drug categories (AMT / MIMS / ARTG) Highly Specialised Drugs Online Claiming (Medicare) Drug Interaction (Stockley) & Allergy checking decision support Scanning during receipt, distribution and dispensing (National Product Catalogue / Suppliers) HPPL Drug Descriptions CSC i.Pharmacy Drug Code Barcodes ARTG ID Contract Linkage PBS Linkage Warning Codes Cautionary Advisory Labels for patients (Australian Pharmaceutical Formulary v22) HPPL Data Information Flow Generation of Consumer Medicines Information leaflets from i.Pharmacy (ARTG)
  9. 9. DevelopmentApproach Editorial Guidelines Build Stakeholder Review Define editorial guidelines for all hospital pharmacy products: • Commercially Traded • Clinical Trials • Local Aseptic • Local Cytotoxic • Local TPN • Local Extemp. • SAS • Alternative Access • Repackaged ‘Cleanse’ existing LHD i.Pharmacy product file according to editorial guidelines Approximately 6 Months (3 FTE) Commence Implementation Develop Support Tools 3000+ products reviewed and editorial guidelines refined • Product Request Tool • Content Management Tool • i.Pharmacy Integration
  10. 10. ImplementationApproach Engage Data Cleansing Data Mapping and Validation UAT 1 ELS Organisation Change Management Support Establish the project Review and cleanse exiting data (products, cost centres, doctors) HPPL Team Map local products to HPPL products Generate questions for LHD Add all missing products Communication and training LHD Team Validate product mappings Answer questions Agree rejected list August - September October - November December UAT 2 LHD Team Test consolidated database Test all scenarios including: Manufacturing Dispensing Stockley Restricted notes Data extract & mapping LHD Resource Intensive Tasks Go Live
  11. 11. ImplementationProgress New South Wales Metropolitan = in progress (complete by Dec 2013) = complete (over half the State)
  12. 12. Requests for new products are submitted electronically through the Product Request Tool. Data alignment with terminology standards and clinical review is performed centrally by the HPPL team. Updated product data is distributed electronically to all LHD i.Pharmacy databases every 15 minutes HowistheHPPLSupported? Data changes replicated to LHDs every 15 minutes Pharmacist Review
  13. 13. Managingmultipleversions Multi-version Target State
  14. 14. FutureOpportunities HPPL NSW Master Drug Catalogue Pharmacy Data Warehouse Reconciliation Prescribing Procurement Dispensing Administration Discharge Spend analysis Usage analysis ABF Ad hoc reports
  15. 15. NSWMasterDrugCatalogue
  16. 16. Summary Achievements Terminology standards implemented + supported Efficient product request management process State-wide account codes for drugs consolidated Governance model approved Ongoing support service established Opportunities Foundation for wider medicines data standardisation Foundation for efficient medicines usage reporting
  17. 17. Questions

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