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Waitemata DHB extends electronic prescription of medicine

20 June 2013

Waitemata DHB takes lead on electronic prescription of medications

Patient safety and quality of care is set to improve even further at Waitemata District Health Board with the expansion of electronic prescribing and administration of medications at its main clinical sites.

Following its introduction to 60 beds at North Shore Hospital late last year, ePrescribing has been rolled out to a further 45 beds at Waitakere Hospital, as well as 110 beds at the DHB-run Mason Clinic, the Auckland region’s forensic psychiatric care facility.

Minister of Health Tony Ryall was at the DHB this week to see the ePrescribing system in action, as well as celebrate the signing of a national contract to provide MedChart for ePrescribing, which all DHBs will be implementing.

In total, the ePrescribing system now covers more than 200 beds at the DHB, with the number set to rise further early next year with the planned introduction to six more wards at North Shore Hospital. The roll out makes Waitemata the first DHB with such an extensive expansion of ePrescribing planned.

“The move means that there is increased safety around the medications patients are prescribed and administered,” says David Ryan, Waitemata DHB’s ePrescribing project leader.

Internationally, ePrescribing has been shown to support the entire medicines use process and Waitemata DHB – the first in the upper North Island to roll out the regime – has already seen benefits, including:

·         Automated alerts when patients have a documented allergy to a medicine being prescribed
·         Drug interaction alerts from the New Zealand Formulary
·         Dose range alerts for prescriptions outside the usual minimum or maximum dosage
·         Complete legibility of prescriptions
·         Reduced transcription errors
·         Ease of access to prescription information
·         Improved clinician decision making around the choice of medicines and other therapies

“By having electronic prescribing, we can reduce the risk of patients experiencing avoidable issues with their medication, such as allergies or adverse reactions to certain drugs,” says Mr Ryan, “For patients with multiple health conditions on a number of different medications, it can also flag up potential drug interactions that could cause harm.”

Waitemata DHB is a national leader in the use of technology to improve medication safety.  Earlier this month, the ePrescribing team led by Mr Ryan were named Hospital Pharmacy Performer of the Year at the 2013 Pharmacy Awards.

Waitemata DHB CEO Dr Dale Bramley says the rapid expansion of ePrescribing will further improve patient safety and quality of care at the DHB.

“Implementing ePrescribing is a core part of our commitment to providing the best care possible to every patient who comes through our doors.”

The roll-out of ePrescribing is part of the DHB’s Medications Safety Strategy, which aims to make systematic change and improvement to the way medicines are handled and used.

International research suggests that across the health sector, approximately 50% of medication harm occurs during prescribing, 40% during administration, and 10% during dispensing and distribution.

The Institute of Healthcare Improvement recommends automation and computerisation as among the most effective tools for preventing medication errors.

Waitemata DHB is considered to be a Centre of Excellence in electronic medicines management by the National Health IT Board, and has long pioneered innovation in this field.

It was one of the first DHBs in New Zealand to implement the Pyxis Medstation automated medicine distribution system in 2001, and was also an early adopter of Smart infusion pump safety software, ensuring common medicines administered by infusion pump are delivered within safe limits.

It has also done a lot of work in the area of medicine reconciliation (the process of collecting, comparing and communicating the most accurate list of all medicines that a patient is taking). An average of 2,600 patients admitted to Waitemata DHB hospitals each month have medicine reconciliation initiated, with 75% of these occurring within 24 hours of admission.

The Waitemata DHB Quality Use of Medicines team also created the SafeRx website aimed at providing succinct and up-to-date messages for health professionals about the safe use of high risk medicines. The website is linked to GP computer software, and is accessed by community based doctors, nurses and pharmacists.


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