The following is an excerpt from a recent report on medication safety systems:
The tower of Babel stands—or rather does not stand—to remind us that nothing thwarts progress more fully than the inability to communicate.
In 2005, the Institute of Healthcare Improvement (IHI) set out to save 100,000 lives that may otherwise be lost to preventable medical error. While the IHI focused on only six best practices, there are nearly as many routes to improved safety as there are lives to be saved. Yet, there is universal agreement that medication errors are among the greatest threats to patient safety.
The inpatient medication use process is a mosaic of hundreds of components including cultural redefinition, caregiver training, and technological advancement. An example of the latter is the concept of a closed-loop medication management system in which all individuals participating in the process—physicians, nurses, and pharmacists—tap a single vein through which medication orders flow. From prescribing, to dispensing, to administration and documentation, each care provider is connected to a single source of information that provides real time notification of patient status.
A closed-loop system links the core components of the medication use process: electronic medication reconciliation, computerized provider order entry, a pharmacy information system, and the electronic medication administration system to facilitate safe point-of-care administration and documentation.
These tools are essential to closing the loop and realizing medication safety. But like our friends in Babel learned, if they don’t speak the same language, communication is irrelevant, performance suffers and risk is the result.
Building the Solution?
Unlike humans, computers cannot read body language, do not perceive inflection, can neither imply nor infer, and completely lack the art of sarcasm. Thus, the more systems share in a common language, the more effectively they exchange information.
However, with the widespread use of varied technologies, platforms and architectures, systems that do not share a single language must frequently be linked across an enterprise. For example, between a pharmacy information system and a nursing documentation system may be a bi-lingual interface that spends its days translating data, e.g., dates from 09/21/06 to 9212006 and back again.
Interfaced systems are especially common in hospitals to combine the wide variety of care systems—pharmacy information system from one manufacturer, for example, and barcode point-of-care system from another—through software interfaces to share patient data throughout the care cycle. Conversely, in an integrated system, applications share a single database, thereby eliminating the need for translation interfaces altogether. Although integrated systems are generally thought to be single-vendor or catalog solutions, most clinical information system (CIS) vendors’ “integrated suite†are actually a collection of acquired assets loosely strung together behind the screens with complex interfaces.
Which approach is best for medication safety? The ideal approach would result in flawless computer-to-computer communication at the least expense and provide the greatest benefit to the clinician workflow. So which is it, integrated or interfaced? In a word, yes.
Download the full report:
http://www.mediware.com/mm/safetybydesign/
