Electronic Medication Management ( eMM )

1. Electronic Medication Management (eMM) Dr Stephen Chu Chief Clinical Informatician & Terminologist Clinical Terminology & Information, NEHTA • Landscape and Concepts • eMedication Management Stack • concepts and scope

2. eMM: Landscape • Electronic Medication Management • Three key components • Contents • Infrastructures • Trigger events; messages; services • Registry; repository • Applications/User interface/viewer

3. eMM: Landscape • Electronic Medication Management • Key landscape components Applications Triggers Registry/ Directory eMM Repository SEHR/ PHR Services Messages Queries Contents Interfaces

4. eMM: Landscape The recipes • Electronic Medication Management • The recipes and ingredients analogy The production (cooking) processes The consumptions Medication Management Plan Executive/ Management Decisions Medication Management Medication Profile Reconciliation Reconciled Medication History List Reviews Medication Review Record Clinical Decisions Queries Unreconciled Medication History List Patient Medication Record Medication related Reporting The data (ingredients) Labs … & others… Pharm Advice Dispense Records Patient Conditions Allergies; Adv reactions Contra- Indicat -ions Meds Admin Prescrip-tions The sources hospitals Community pharmacies Community Labs/paths Community Imaging services others …

5. Medication Profile • Definitions • Medication Profile • A set of information about characteristics of a patient’s medication use • Medication Management Profile • A set of information about a patient’s characteristics, which are relevant to safe medication management for this patient

6. eMM: Landscape The recipes • Electronic Medication Management • Key components The production (cooking) processes Medication Management Plan Medication Profile Reconciliation Complexity Reconciled Medication History List (processing, … etc) Reviews Medication Review Record Queries Unreconciled Medication History List Patient Medication Record Medication related Reporting Data components Prescribed √ Dispensed √ Administered ??? Administration/conformance Profile: Max cumulated dose Omission frequency + reasons Dose variation frequency + reasons Frequency variation frequency + reasons Intermittent + PRN frequency + reasons

7. eMM: Landscape The recipes • Electronic Medication Management • Key components The production (cooking) processes Medication Management Plan Medication Profile Reconciliation Reconciled Medication History List Complexity Reviews Medication Review Record (processing, … etc) Queries Unreconciled Medication History List Patient Medication Record Medication related Reporting Data components Long term meds list Short term/episodic meds list Intermittent meds list PRN meds list Types of med list view

8. Medication data requirement analysis The recipes • Top down and bottom up approaches The consumptions The production (cooking) processes Top down analysis Medication Management Plan Executive/ Management Decisions Medication Management Medication Profile Reconciliation Complementary Cross-referencing Validating Adequacy, accuracy reusability and consistency checks Reconciled Medication History List Reviews Medication Review Record Clinical Decisions Queries Unreconciled Medication History List Patient Medication Record Medication related Reporting Bottom Up The data (ingredients) Labs … & others… Pharm Advice Dispense Records Patient Conditions Allergies; Adv reactions Contra- Indicat -ions Meds Admin Prescrip-tions The sources hospitals Community pharmacies Community Labs/paths Community Imaging services others …

9. eMM: Landscape • Electronic Medication Management • Three key components • Contents • Infrastructures • Trigger events; messages; services • Registry; repository • Applications/User interface/viewer

10. Medication data – how they are used: through application/Interface design