This document discusses developing a standardized computable "dose syntax" for representing community medication information across different healthcare systems. It proposes a solution that combines an openEHR archetype structural model with a parsable syntax to capture dose amounts and timings. Examples of the syntax are provided to represent prescriptions like "10mg twice daily" in a way that is computable. The goal is to improve medication reconciliation at care transitions by making prescription data electronically exchangeable and analyzable across primary, community, and secondary care settings. Feedback is sought on implementing this approach.
Mediref's communication platform that allows health practitioners to collaborate with each other has a wide range of applications in the pharmaceutical sector.
Transformation Case Study: Chester County HospitalNathaniel Palmer
Utilizing BPM within an acute healthcare setting is an exciting new frontier that offers many opportunities and unique challenges. This presentation will review the acute healthcare setting from a BPM perspective and then present two BPM projects that have resulted in successful automations at The Chester County
Hospital. The first example reviews the automation of the bed cleaning process from a clinical care management perspective. The second example shows how BPM was utilized to monitor all patients for an infectious disease state which requires isolation to protect other patients and the hospital staff. These two
projects resulted in the hospital winning the 2006 North America Global Excellence in Business Process Management (BPM) and Workflow Gold Award. This session will help the participant understand the
healthcare environment and how BPM can successfully be utilized with clinical care processes.
Mediref's communication platform that allows health practitioners to collaborate with each other has a wide range of applications in the pharmaceutical sector.
Transformation Case Study: Chester County HospitalNathaniel Palmer
Utilizing BPM within an acute healthcare setting is an exciting new frontier that offers many opportunities and unique challenges. This presentation will review the acute healthcare setting from a BPM perspective and then present two BPM projects that have resulted in successful automations at The Chester County
Hospital. The first example reviews the automation of the bed cleaning process from a clinical care management perspective. The second example shows how BPM was utilized to monitor all patients for an infectious disease state which requires isolation to protect other patients and the hospital staff. These two
projects resulted in the hospital winning the 2006 North America Global Excellence in Business Process Management (BPM) and Workflow Gold Award. This session will help the participant understand the
healthcare environment and how BPM can successfully be utilized with clinical care processes.
The Pre-Anesthesia Evaluation Module is designed to manage the data and workflow of pre-anesthesia evaluation, either at the pre-admission testing visit or at the surgeon’s office. Medical history is collected from patients via a self-administered Tablet questionnaire, and available data regarding that patient is also downloaded from the EHR. This data is used to determine what testing is needed prior to anesthesia. This system can be used in the surgeon’s office, to help avoid anesthesia complications and help prevent canceled or delayed cases. A set of screenshots and an overview of the module can be reviewed via this downloadable PowerPoint presentation.
Current Clinical Decision Support tools and solutions have no doubt brought a great deal of value to physicians and patients, e.g. online reference tools and mobile applications. Infera is an advanced clinical decision support system (CDSS) that seamlessly integrates with your EHR and the clinician workflow. For more detail visit here: https://bit.ly/2BhkxI0
Patient Experience Measures: Past and FutureBivarus
What is the value of measuring the patient experience? Kevin Schulman, MD shares data on why measuring the patient experience is important in today's changing healthcare environment.
Predictive Analytics is already being leveraged in several sectors and has helped businesses gain efficiency. In the field of healthcare, Predictive Analytics promises to improve healthcare by forecasting the likelihood of an event enabling healthcare providers to take pre-emptive action where possible.
Predictive Analytics uses statistical analysis and other techniques to search through reams of patient data and analyses it to predict outcomes for individual patients.
A case of chronic liver and kidney failure in js dog at jibachha veterinary ...Dr. Jibachha Sah
Chronic liver failure can be caused by chronic exposure to toxins, heavy metals (copper, iron and zinc), chronic infections, chronic inflammation/irritation, cancer, blood vessel abnormalities (congenital portosystemic shunt – an abnormal blood vessel that a pet is born with that bypasses the liver), immune disease.Data of serum chemistry indicated severe renal failure and mild hepatic damage.This is case of Jibachha veterinary hospital,Kathmandu,Nepal.
The Pre-Anesthesia Evaluation Module is designed to manage the data and workflow of pre-anesthesia evaluation, either at the pre-admission testing visit or at the surgeon’s office. Medical history is collected from patients via a self-administered Tablet questionnaire, and available data regarding that patient is also downloaded from the EHR. This data is used to determine what testing is needed prior to anesthesia. This system can be used in the surgeon’s office, to help avoid anesthesia complications and help prevent canceled or delayed cases. A set of screenshots and an overview of the module can be reviewed via this downloadable PowerPoint presentation.
Current Clinical Decision Support tools and solutions have no doubt brought a great deal of value to physicians and patients, e.g. online reference tools and mobile applications. Infera is an advanced clinical decision support system (CDSS) that seamlessly integrates with your EHR and the clinician workflow. For more detail visit here: https://bit.ly/2BhkxI0
Patient Experience Measures: Past and FutureBivarus
What is the value of measuring the patient experience? Kevin Schulman, MD shares data on why measuring the patient experience is important in today's changing healthcare environment.
Predictive Analytics is already being leveraged in several sectors and has helped businesses gain efficiency. In the field of healthcare, Predictive Analytics promises to improve healthcare by forecasting the likelihood of an event enabling healthcare providers to take pre-emptive action where possible.
Predictive Analytics uses statistical analysis and other techniques to search through reams of patient data and analyses it to predict outcomes for individual patients.
A case of chronic liver and kidney failure in js dog at jibachha veterinary ...Dr. Jibachha Sah
Chronic liver failure can be caused by chronic exposure to toxins, heavy metals (copper, iron and zinc), chronic infections, chronic inflammation/irritation, cancer, blood vessel abnormalities (congenital portosystemic shunt – an abnormal blood vessel that a pet is born with that bypasses the liver), immune disease.Data of serum chemistry indicated severe renal failure and mild hepatic damage.This is case of Jibachha veterinary hospital,Kathmandu,Nepal.
Ομιλία – Παρουσίαση: Raymond Anderson, President Commonwealth Pharmaceutical Association and Member of the Pharmacovigilance Risk Assessment Committee (PRAC) at EMA
«Best Practices to inform citizens on Self-medication»
Medical Related information reconciliation when a patient sees many providers or transfers between health facilities is challenging. Lack of updated and correct information is a key concern for patient safety during a health and illness trajectory [1]. Errors, near misses and adverse medication events are too common, particularly whne transfers between hospitals, nursing home and home are frequent, or engagement of multiple specialties is common [2]. Lack of effective informatics support can be harmful to a person’s health, leading to suffering, increased use of health care resources and increased costs.
As a case for interactive discussion, we have chosen information exchanges related to medication, prescription-based as well as over the counter drugs. This challenging chain of activities includes: (a) prescribing on paper or electronically by several medical specialists, (b) transcribing by sending and interpreting prescriptions in the pharmacy, (c) dispensing medication by brand name or generic substitution, (d) acquiring over the counter medication, (e) administering medication as a user, and (f) observing effects and side-effects. The risk of missing information leading to mistakes in the chain of activities in medication management is likely to increase as complex medication regimes become common due to demographic developments, co-morbidities or more personalized treatment. Potentials in patient activation and relevant informatics tools for medication reconciliation need further exploration.
Anne MOEN Institute for Health and Society, Faculty of Medicine, University of Oslo, NORWAY
Catherine CHRONAKI HL7 Foundation, Brussels, BELGIUM
Christian NØHR, Aalborg University, DENMARK
Line Helen LINSTAD Norwegian Center for eHealth Research, Tromsø, NORWAY
Petter HURLEN Akershus University Hospital, NORWAY
Pharmacist Interventions and Medication Reviews at Care Homes - Improving Med...Health Innovation Wessex
The Health Innovation Network Polypharmacy Programme is working with healthcare professionals to address problematic polypharmacy by supporting easier identification of patients at potential risk from harm from multiple medications.
Our evidence-based polypharmacy Action Learning Sets (ALS) are being rolled out across England to support GPs, pharmacists and other healthcare professionals who undertake prescribing or medication reviews to understand the complex issues around stopping inappropriate medicines safely.
To drive and accelerate changes in practice, delegates complete a quality improvement project to address problematic polypharmacy in their workplace. This poster summary, Pharmacist Interventions and Medication Reviews at Care Homes - Improving Medication Safety and Patient Outcomes, can be viewed here.
For more information about the polypharmacy programme, please visit https://thehealthinnovationnetwork.co.uk/programmes/medicines/polypharmacy/
For more information contact: Slideshare@marcusevans.com
Presentation delivered by Donna Medina, Regional Director,OSF Hospice and Homecare Foundation at the marcus evans Home Care Leadership Summit held on July 13 & 14 2015 in Palm Beach FL.
Comprehensive and person centred approach to addressing Polypharmacy in adult...Health Innovation Wessex
The Health Innovation Network Polypharmacy programme is working with healthcare professionals to address problematic polypharmacy by supporting easier identification of patients at potential risk from harm from multiple medications.
Our evidence-based polypharmacy Action Learning Sets (ALS) are being rolled out across England to support GPs, pharmacists and other healthcare professionals who undertake prescribing or medication reviews to understand the complex issues around stopping inappropriate medicines safely.
To drive and accelerate changes in practice, delegates complete a quality improvement project to address problematic polypharmacy in their workplace. This poster summary, Comprehensive and person centred approach to addressing Polypharmacy in adult care home residents, can be viewed here.
For more information about the polypharmacy programme, please visit https://thehealthinnovationnetwork.co.uk/programmes/medicines/polypharmacy/
Medicines optimisation, pop up uni, 9am, 3 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Introduction of the NZ Health IT Plan enables better gout management - Reflections of an early adopter. Presented by Peter Gow, Counties Manukau DHB, at HINZ 2014, 12 November 2014, 11.37am, Plenary Room
1. A Dose syntax for community
medication?
Dr Ian McNicoll
SCIMP
HANDIHealth
openEHR
Gyle meeting April 2015
2. Introduction
Former Clydebank GP
Health Informatician since 2000
freshEHR Clinical Informatics
Co-chair openEHR Board
SCIMP
HANDIHealth
Commercial software developer
‘GP Accounts’
3. Community medication
stakeholders
GPs
Nursing
Mental health teams,
Pharmacy
Secondary care inpatients
Secondary care outpatients
Nursing homes
Unscheduled care
Patients
GP prescriptions
anticipatory care supply
repeat dispensing
transitions of care
own supply
patient access
patient-led reconciliation
4. Current position
No clear visibility of other prescribers actions
Patient often only the knows the whole picture
No clear governance
Non- standardised representation of medication
between systems
5. What’s the solution?
‘Closing the Loop’ commission
‘patient medication record’
‘community’ record
Inpatient prescribing excluded other than at
transitions of care
8. The interoperability challenges
How do we resolve the ‘wicked’ interoperability
issues?
Standardised, computable ‘medication models’
‘Medication event’ vs. ‘Medication statement’
Product vs. dose based prescriptions
Computable dose amounts / timings’
9. NHSS Medication Models
Based on GP2GP medication models
merge in requirements for
ECS / KIS / ePharmacy / SCI-GW
Other UK models : SCR, IHR, EPS2
Aligned with PRSB / RCP Headings
Can we persuade systems suppliers to adopt?
10. Modelling approach
Based on openEHR but technology neutral
models of ‘clinical content’
Exchange -> messages / APIs
SCI-XML, GP2GP, HL7 FHIR inte
can be used natively inside openEHR-based systems
Aligned with dm+d, CUI
11. open, shared data models -
‘Archetypes
• Clinically-led + collaboratively authored
– open-source ‘crowd-sourcing’ methodology
– Shared open repository ‘CC-BY-SA’ licence
• Agility in response to continually changing clinical
demand
– Clear ownership, change request mechanism
– Tight version control
13. Product vs dose based
prescribing
Unavoidable
due to difference in the process of
inpatient vs. outpatient prescribing
Dose:
Product:
14. Dose syntax??
How can we capture a prescription like …
“Co-codamol 8mg/500mg/5ml oral suspension 5-
10mls 4-6hourly for 7 days for pain, maximum
40mls daily”
that makes the drug name, dose amount, timing
and maximum dosage computable
15. Dose syntax - aims
GP, outpatient, community, transitions of care prescriptions
support automated medicines reconciliation at transitions of care
calculate Total Daily Dose for quality assessment purposes
explore usage as data entry method
Out of scope
inpatient prescriptions
complex GP prescriptions
patient usage instructions ‘before meals, ‘take with water’
16. Dose syntax - sources
Blue Wave / English NHS /CfH Dose syntax work
Comprehensive, complex
Low uptake
Uni. Dundee ‘EBNF’ Dose syntax
Successful use as research tool
Confined to GP prescriptions