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Medication Use Process Errors and Bar Code Scanning

BCMA @ HSCQC, January 9, 2012 BAR CODED MEDICATION ADMINISTRATION (BCMA) UM- CareLink BCMA Solution Implementation Projects Project A: Bi-directional interface activation Project B: Implement bar code medication scanning . Medication Use Process Errors and Bar Code Scanning.

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Medication Use Process Errors and Bar Code Scanning

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  1. BCMA @ HSCQC, January 9, 2012BAR CODED MEDICATION ADMINISTRATION (BCMA)UM-CareLinkBCMA Solution Implementation ProjectsProject A: Bi-directional interface activationProject B: Implement bar code medication scanning

  2. Medication Use Process Errors and Bar Code Scanning

  3. Impact and Prevalence of BCMA • Poon, et al. : Observed 14,041 medication administrations and reviewed 3082 order transcriptions. 11.5% error rate without BCMA vs. a 6.8% error rate when BCMA used — a 41.4% relative reduction in errors (P<0.001). T • The rate of potential adverse drug events (other than those associated with timing errors) fell from 3.1% without the use of the bar-code eMAR to 1.6% with its use, representing a 50.8% relative reduction (P<0.001).   • Morriss results in the neonatal ICU: A total of 92 398 medication doses were administered to 958 subjects. The BCMA system reduced the risk of targeted, preventable ADEs by 47%, controlling for the number of medication doses/subject/day. • 2011 ASHP survey of 1401 hospitals: 50% of hospitals have adopted BCMA and 66% of hospitals > 600 beds have adopted BCMA.

  4. CURRENT STATE: Cannot Scan UM-CareLink SCMCPOE AllscriptsEclipsysSCM 5.0 -CPOE Medication Order Messages MediwareWORxPharmacySystem WBIInterfaceEngine eMAR Pharmacy Verification Signal Only Open Loop

  5. PROJECT A: Activate Interface UM-CareLink SCMCPOE SCM-CPOE Medication Order Messages MediwareWORxPharmacySystem WBIInterfaceEngine eMAR SMM-KBMABar CodingSystem Pharmacy Verification &Dispensed ProductInformation Closed Loop

  6. PROJECT B: Implement Scanning Image from:http://www.stjohns.com/news/images/mercymeds.jpg

  7. Success Factors Fix known interface issuesAddress UMCL 5.5 upgrade/Windows7 dependenciesOvercome internal resource competitionIdentify and assign necessary specialistsProductive vendor relationshipsEnterprise-wide commitment to BCMA

  8. Projects A & B: Incremental Budget Needs Original Capital$1.95M Funds RemainingEquipment to PurchaseAvailable$300K MCIT $200K Scanners $100K MCIT$150K Nursing $150K NursingAdditional Incremental (New) Costs Estimates*$210K + $250K - $100K = $360K Labor MCIT$20K + $200K - $150K = $70K Labor Nursing$50K + $25K = $75K Labor Pharmacy$60K + $0 = $60K Server/Hardware $80K + $60K = $140K Vendor Services*Pending refinement and finalization of actual additional capital request +$705K

  9. High level time-line & sequence BCMA Project B: Nurse Scanning Roll-out 6 Months BCMA Project A, Interface: 7 Months Nov Jan‘13 Feb ‘12 Sep Apr ‘13 Pilot UM-CareLink 5.5 Upgrade Jan ‘12 Sep

  10. Trade-offs – BCMA in 2012 means deferring these: + WORx pharmacy system upgrade + eMAR interface to TheraDOC+ Rx IV room bar-code scanning system+ Now & Then CPOE (600mg now & then 300mg BID) + Insulin CPOE enhancements + Controlled substance CPOE enhancements + Restricting use of “as directed” in CPOE

  11. We have the capacity for BCMA in 2012 + Nursing staff ready to support project+ Pharmacy staff ready to support project+ Medication-use system IT experts ready+ Plan for Quality Assurance & Interface engineersBCMA would continue alongside UM-CareLink 5.5 Upgrade & along with building up the MiChart pharmacy team.

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