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Urbanisation de la prise en charge médicamenteuse, questions

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Urbanisation de la prise en charge médicamenteuse, questions

  1. 1. Simon LETELLIER, Pharmacien, Secrétaire ADIPh, Secrétaire IHE Pharmacy Urbanisation de la prise en charge médicamenteuse, questions 28 janvier 2014 Atelier GDR liés à l’informatisation de la PECM
  2. 2. Pas conflit de intérêt à déclarer Liens à déclarer : Sanofi Aventis France – 12 mars 2012 – Restauration Air Liquide Santé – 29 mars 2012 – Réunion régionale Takeda – 15-16 mars 2013 - Réunion Douleur Lilly – 6-7 février 2014 – Journées Pharmacien
  3. 3. Enoncé «Si des logiciels dysfonctionnent, ils seront évidemment retirés. Il n'est pas acceptable que la vie de patients ou l'avenir de patients soient mis en danger pour cette raison» Marisol Touraine 07/2013 Résultats d’un AO pour le choix d’un logiciel de DPI -Alma : Cristal-Net Licence logicielle 0€ Adhésion « maintenance éditeur » A 000 € « mise en œuvre » B 000€ Hébergement annuel C 000 € Installation et paramétrage & Formations - Axigate : aXigate D 000€ - Calystène : Futura E 000 € - McKesson France : CrossWay F 000€ Maintenance annuelle G 000 € - Syndicat Interhospitalier de Bretagne : Sillage H 000€ + maintenance J 000€
  4. 4. Ref : Introduction des nouvelles technologies en santé : analyse des principaux risques liés à l’informatisation de la prescription médicale – LEMESLE Auriane – 2010/2011 – page 2
  5. 5. Directeur RSIO Ref: Présentation du Guide d’Interopérabilité Intra-hospitalier Version 2012 - HIT – 23 mai 2012
  6. 6. Ref: Présentation du Guide d’Interopérabilité Intra-hospitalier Version 2012 - HIT – 23 mai 2012
  7. 7. Quels sont les meilleurs SIH possibles ? SIH et SIPh Ref :Hospital Modular Facilities http://www.flickr.com/photos/33682730@N06/4199627658
  8. 8. Ref : Domain Reference Model for Hospitals version 2 – Nictiz – 12 juin 2012 – 54 pages
  9. 9. Quelles spécificités à la PECM ? Un peu plus compliqué encore que les PSL
  10. 10. Patient Safety through Intelligent Procedures in medication Sécurité des patients et procédures intelligentes pour la prescription Fouille de données Ref : http://psip-portal.univ-lille2.fr/portal http://www.parhtage.sante.fr/re7/npc/doc.nsf/$All/ORTIS7PCRD
  11. 11. UML (Unified Modeling Language) Langage de modélisation unifié
  12. 12. Valider les connexions Avril 2011 : Connectathon européen à Pise Environ 300 informaticiens
  13. 13. Argumentaire DPI de Calystène Ref : http://futura-smart-design.catalyzis-group.com
  14. 14. Ergonomie (Web & référentiels) Microsoft Health Common User Interface Ref : http://mscui.codeplex.com http://www.mscui.net
  15. 15. Utilisabilité • Evaluation heuristique – Analyse d’interface à l’aide de critères • Inspection cognitive – Evaluation de la facilité d’utilisation et d’apprentissage par l’exploration • Test d’utilisabilité – Test d’observation directe de l'utilisateur en train de se servir de l'application. Ref : http://evalab.univ-lille2.fr/fr/methodes.html
  16. 16. Electronic Medical Record Adoption Model PharmNet de Cerner http://www.cerner.com/solutions/Hopitaux_et_Systeme/Presentation_des_Solutions_de_Pharmacie • • • • • • • Analyse pharmaceutique peu pratique/facilitée Interventions pharmaceutiques non visibles par les médecins Pas d'alertes pour la réévaluation des ATB Substitutions non opérationnelles, Pas de modalités de bonne administration (cpr à écraser, ouverture de gélules) Pas de possibilité de gérer de la DHIN etc.
  17. 17. API : unhappy ! Logiciel métier API BDM • Certification des LAP • Agrément des BDM v2 Calystène  Thésorimed Mc Kesson  BCB SIB  Thériaque
  18. 18. Pharma Computer Engineering Elite Agfa Healthcare CH L’Aigle
  19. 19. Pharma - Newac Computer Engineering 1- Fichier (fournisseurs, marchés, produits) : Elite  Pharma 2 - Réceptions de commande Pharma  Elite 2bis- Sorties de stock (inventaires compris ? ) Pharma  Elite Elite Agfa Healthcare 3 – MAJ PMP Elite  Pharma CH L’Aigle
  20. 20. Pharma Computer Engineering 1- Fichier produit : Elite  Pharma 2 - Sorties de stock (inventaires compris ) Pharma  Elite Elite Agfa Healthcare
  21. 21. Pharma Computer Engineering 1- Fichier (code GEF) produit : GEF  Pharma 2 - Liquidations Pharma  GEF Evoluance GEF Mc Kesson CH Niort
  22. 22. CrossWay McKesson Pharma Computer Engineering CHU Caen CH Niort Evoluance GEF McKesson
  23. 23. Cristal-Net Co-Pilote 1- Fichier produit : Magh2  Copilote Magh2  Cristal.Net 2 - Réceptions de commande Magh2  Copilote 2bis- Sorties de stock (inventaires compris ) Préconisations de commande (produits stock et hors stock) Copilote  Magh2 Magh2 3- Demande de réassort Cristal .Net  Copilote 3bis - Délivrance Copilote  Cristal.Net CH Lisieux
  24. 24. De la traçabilité des produits à celle des activités • Vocéra • Tracking Col • Copilote Santé
  25. 25. Conclusion Programme Optimisation de l'usage des SI pour les établissements sanitaires et médicosociaux Audit des SIH sur 3 critères : - charge supportée par le SI (établissements MCO avec service d'urgences) - complexité du SI (couverture fonctionnelle). - configuration logicielle utilisée (offre logicielle existante).
  26. 26. Conclusion Ref : http://www.sante.gouv.fr/atlas-des-systemes-d-information-hospitaliers-sih.html http://www.anap.fr/detail-dune-publication-ou-dun-outil/recherche/diagnostiquer-les-risqueslies-a-linformatisation-du-circuit-du-medicament/
  27. 27. Des questions ?

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