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IHE Pharmacy domain Profiles for Community and Hospital Pharmacy

IHE Pharmacy domain Profiles for Community and Hospital Pharmacy. Jürgen Brandstätter IHE Pharmacy co-chair. Radiology since 1998. Cardiology since 2003. Pathology since 2006. Laboratory since 2003. Eye Care since 2006. (Healthcare) IT Infrastructure since 2003.

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IHE Pharmacy domain Profiles for Community and Hospital Pharmacy

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  1. IHE Pharmacy domainProfilesforCommunity and Hospital Pharmacy Jürgen Brandstätter IHE Pharmacy co-chair

  2. Radiologysince 1998 Cardiologysince 2003 Pathologysince 2006 Laboratorysince 2003 Eye Caresince 2006 (Healthcare)IT Infrastructuresince 2003 Radiation Oncologysince 2004 QualityResearch & Public Healthsince 2007 Patient Care Coordinationsince 2005 Patient Care Devicessince 2005 Pharmacy within IHE landscape Quelle: IHE International PharmacySince 2009 since 2008

  3. IHE Pharmacy overview • Pharmacy (PHARM) • Since 2009 • “IHE Pharmacy addresses information sharing, workflow and patient care in both community and hospital pharmacies.” • 1 whitepaper, 5 profiles • Sponsors & Supporters • EAHP • NICTIZ • RéseauPhast

  4. Ourneedsin community Cover the overall process from prescription at the GP to dispense at the Pharmacy

  5. Ourneedsin hospital Cover the overall medication workflow from prescription via validation and dispense to administration to the patient

  6. Howtoparticipate in Pharmacy … Participate IHE’s Profile Cycle • Committee work follows the IHE Profile Cycle • Annual cycle • Sep – Dec: Call for proposals • Dec – Jun: Working on work-items • Jun – Jul: Public comment • Jul – Aug: Ballot & Release • Opportunities for IHE members and non-members to participate in cycle (join http://groups.google.com/group/ihe-pharmacy !)

  7. Our approach • Create a common data model for pharmacy domain • Profile existing standards: • Hospital pharmacy: HL7v2.x standard (Message-based) • Community pharmacy: HL7v3 CDA standard (Document-based) • Technical Framework describes the details of each Integration Profile (data model, messages) • Connectathons (first at Pisa, April 2011) to validate implementations of the IHE Pharmacy Integration Profiles • Welcome additional members (users, vendors)

  8. Whathasbeendone? IHE White Paper • Final version (integration of comments collected after having been put for public comments last year) • 70 pages • Community Pharmacy use cases • Hospital Pharmacy use cases • Harmonization of actors definitions ftp://ftp.ihe.net/Pharmacy/White%20Paper/IHE_Eur_Pharmacy_White_Paper_Final_Text_1.2.pdf

  9. Whathasbeendone? • 5 profilesfor … • … Community Pharmacy • CMPD Community MedicationPrescriptionand Dispense • PRE Content Profile: MedicationPrescription • PADV Content Profile: PharmaceuticalAdvice • DIS Content Profile: Medication Dispense • … Hospital Pharmacy • HMW Hospital Medication Workflow

  10. IHE Pharmacy – Key process

  11. Common Data Model • Data Model describe the data elements and their relations • Common for hospital pharmacy and community pharmacy • Derived from the model: HL7v2 messages and CDA documents • HL7v3 CDA • Pharmacy CMETs

  12. 2009-2010 cycle CMPD PRE PADV DIS HMW

  13. Community Pharmacy profiles Existing Profiles with High Uptake • CMPD (Community Medication Prescription and Dispense) • Basic use case • GP prescribes • Someone validates the prescription • Community pharmacist or pharmacy dispenses • Systems it would impact: • Prescription placer module in GP systems • Pharmaceutical validation software • Pharmacy software • Based on IHE ITI XDS: • Strong integration with existing CDA/XDS-based solutions + PRE Medication Prescription + PADV Pharmaceutical Advice + DIS Medication Dispense

  14. CMPD actordiagram

  15. CMPD Workflow scenario PrescriptionPlacer PharmaceuticalAdviser MedicationDispenser Next task: „Validation“ Validation Next task: „Dispensing“ Dispensing Ordering Condition: Always Condition: if PADV exists with statusCode=completed AND code=OK or CHANGE Next task: „Ordering“ Condition: if PADV exists with statusCode=completed AND code=REFUSE Stop Condition: if PADV exists with statusCode=completed AND code=CANCEL PHARM-1 , Query: FindPrescriptionsForDispense PHARM-1, Query: FindPrescriptionsForValidation • Prescription document contains at least one Prescription Item ready to be validated. • A Prescription Item is ready to validate if there exists no Pharmaceutical Advice Item related to it which has statusCode set to “completed”. • Prescription document contains at least one Prescription Item ready to be dispensed. • A Prescription Item is ready to dispense if there exists a Pharmaceutical Advice Item related to it which has statusCode set to “completed” and code=OK or CHANGE.

  16. Content Profiles • Content Profiles define „payload“ of CMPD system • PRE • PADV • DIS • Based on HL7v3 CDA extended by HL7 Pharmacy CMETs

  17. Hospital Pharmacy profiles Existing Profiles with High Uptake • HMW • Basic use case: • Hospital physician prescribe in a ward • Hospital pharmacist review orders • Pharmacy technician dispense • Nurse administers drugs to the patient • Systems it would impact: • Prescription placer • Pharmaceutical advisor • Medication dispenser • Medication administration informer • Based on HL7 v2.x: • Message based to fit into hospital environment 9/18/2014 17

  18. HMW actordiagram

  19. HMW Interoperability Model

  20. Becoming real … • European Union: epSOS • Definition ofprescriptionanddispensedocumentaligned • Austria / Europe: e-Medicationproject • Adoption of PRE und DIS specifications in pilot • Fulladoptionforrollout • Italy / Europe: DOGE project • Veniceregion (5 millioninhabitants)

  21. Roadmap • Currentwork-items • Medicationrecord • Aka „Medicationdocumentation“ / „Medicationtreatment plan“ • Cross-domainworkwithother IHE domainsand HL7 • Exceptionalcases • Extension ofuse-cases in CMPD and HMW • Whitepaper: Supplychain in Hospital Pharmacy • Whitepaper: Transition „Community – Hospital“ • Automatic administrationby Infusion pumps • Cross-domainworkwith IHE Patient Care Devices domain • Common Glossary • Cross-domainwork IHE and HL7 • Upcomingwork-items • HL7v3 messages • Prescriptionof non-medicationproducts

  22. Links • Technical Frameworks • http://www.ihe.net/Technical_Framework/index.cfm#pharmacy • Pharmacy Wiki • http://wiki.ihe.net/index.php?title=Pharmacy • Strategic planningpage • http://wiki.ihe.net/index.php?title=PHARM_Strategic_Planning • Roadmap • http://wiki.ihe.net/index.php?title=PHARM_Roadmap • Committees • http://wiki.ihe.net/index.php?title=Pharmacy_Planning_Committee • http://wiki.ihe.net/index.php?title=Pharmacy_Technical_Committee • Google group • http://groups.google.com/group/ihe-pharmacy

  23. Thank you Jürgen Brandstätter IHE Pharmacy co-chair CodeWerk Software Services and Development GmbH j.brandstaetter@codewerk.at

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