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This article explores the concept of administration versus dispense in a community pharmacy setting, highlighting the distinction between these processes and the importance of accurate medication recording. It delves into the roles of healthcare professionals, digital tools, and various scenarios where administration comes into play for patient care. The text emphasizes the significance of utilizing frameworks like IHE for healthcare information exchange to ensure precise medication lists and patient safety.
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Administration in Community Pharmacy(ADM Profile) Outlook on profilecreation Jürgen Brandstätter, MSc Co-chair, IHE Europe Co-chair, Pharmacy Planning committee Co-chair, Global Deployment Coordination Committee (GDC) Member, IHE International Board CodeWerk Software GmbH, Austria
Administration vs Dispense Dispense A Dispense is an actwheremedicationishandedovertothepatient … orsomeonegettingitforthepatient usuallydone at a Community Pharmacy Itcanberecordedby Healthcare professionals (high „trust“) Downside: Isis not clear, whetherthepatient will takethemedicationor not NearertothetruththanPrescription, fartherthan Administration It‘salways a „one-time“ act (not a time-span act) Special case: partial dispenses, whichareseveral „one-time“ acts Administration An Administration is an actwheremedicationisadministeredintothepatient‘sbody In Community Setting mostmedicationistakenbythepatienthimself, without a Healthcare professional present More andmoretoolsavailableforrecordingthis („apps“) Trustfulenoughtoaddthisinformationtothemedicationlist?? But therearesomecases, where also Administration canberecordedby Healthcare professionals: Controlleddrugadministration in front ofthepharmacist Contrastmedication at theRadiologydepartement Vaccinations Ambulant Chemo therapy Administration ofmedicationbydevices (insulin pump, …) etc. - theybecomemore in thefuture! Administration canbe a „one-time“ act (taking a pill, injection, etc.) OR an time-span act (infusion) More than a Technical Standard: IHE as framework for HIE
Examplefor a simple ADM PRE item Injection 2 times a day for 1 week 5 injections in a package 3 packagestodispense DIS item 1 package with 5 injections ADM item (1 inj) ADM item (1 inj) ADM item (1 inj) DIS item 1 package with 5 injections ADM item (1 inj) ADM item (1 inj) ADM item (1 inj) DIS item 1 package with 5 injections ADM item (1 inj) : ADMs canberelatedto PRE and/or DIS ADMs may also berecordedstandalone
ADM recording One-Time Administration Date/Time: Point ofdate/time Recordedwhathappened at thispointof time 2 pillstaken, 1 applicationofthecream, etc. Time-span Administration Date/Time: Start date/time – End date/time Recorded at the end ofthe time-span Complexscenarios like „drop-rates oftheinfusionchangedduringthe time“ canberecordedeither (1) „summarized“ (averagedrop rate) or (2) „detailed“ (everychangeofthedrop rate isrecordedas separate ADM) ADM recordsmayreferenceanother ADM aspredecessortodocumentthis More than a Technical Standard: IHE as framework for HIE
ADMs in a medicationlist Goal: Makemedicationlistof a patientas „accurate“ aspossible 1) Weknoweverymedicationwhichiscurrentlyactivewithinthepatient‘sbody Best coveredby ADM, becauseit‘sassuredthemedicationenteredthepatient‘sbody If ADM not available: DIS 2) Weknoweverymedicationwhichthepatientisgoingtotake in thefuture DIS: This medicationthepatientalreadyhas in hishandsand will mostlikelytake MTP: This medicationisplanned Medicationlisthierarchy DIS beatsits PRE ADM beatsits DIS More than a Technical Standard: IHE as framework for HIE
Integrate ADM into CMPD Other CPs required also for MTP, PML Medication Administration performer More than a Technical Standard: IHE as framework for HIE
Jürgen Brandstätter, MSc juergen.brandstaetter@ihe-europe.net j.brandstaetter@codewerk.at
