Barcodes: tracing implants and medication during the clinical pathway of patients

Transcription

1 Barcodes: tracing implants and medication during the clinical pathway of patients

2 Welcome! Agenda Esther Peelen, sector manager Healthcare Providers at GS1 Netherlands Introduction Demo HL7 FHIR Decoding barcodes: how does it work? What does this mean for the patient and the care provider? Wrap up

3 Why is tracing implants and medication so important? Famous affairs of MoM hip and PIP implant recalls Failure of current recall systems Safer registration processes inside hospitals and clinics No more waste! Need for more efficient inventory management

4 Hospital pharmacists want single unit barcoding for safe medication administration Over 50% reduction of errors at administration

5 Regulations and agreements on unique identification of medical devices 1. EU Medical Devices and IVD Regulations in EU (MDR) starting May 2020, US and other countries 2. Agreements on barcoding medical devices, July 1 st National Implant Registry (LIR), July 1 st 2018

6 EU Falsified Medicines Directive Implementation date 9 February 2019 ProductId Batch nr Expiry date Serial nr

7 Support by IT-systems is crucial Scanning and processing in Electronic Medical Record, ERP, Hospital Information System, Hospital Pharmacy System of:

8 It s a joint effort!

9 The business case for IHE Pharmacy Michael Tan Product manager Nictiz Co-chair IHE Pharmacy

10 Outcome goals Min. of Health Information Board outcome goals: 1. Medication safety 2. Patient Empowerment 3. Patient Care transfer 4. Single registry and reuse of data

11 Ageing of the Netherlands

12 Patients with chronic illness Some facts The Netherlands have 5,3 million patients with chronic illness. 3,7 million are elderly patients 2 million patients have more than 1 disorder. 40% of elderly people use more than 5 medications 5,3 million (31 %) 17 million inhabitants (source: Nationaal Kompas)

13 Medication Incidents Reported PRESCRIBING TRANSFER MEDICATION VALIDATION PREPARATION DISTRIBUTION ADMINISTRATION MONITORING LOGISTICS Percentage Source CMR 2014

14 Five principles of medication safety: 1. The right patient 2. The right medication 3. The right dosage 4. The right route 5. The right time Reduce Medication Errors

15 Home care for elderly patients

16 IHE Profiles IHE Pharmacy has published 2 profiles:

17 Role HL7 Michael van der Zel, Information Architect at UMC Groningen Working group s choice for HL7 FHIR Active member HL7 International and HL7 Netherlands Demo of decoding of standardised barcode Patient, Care provider, medication and Hip prosthesis

18 How does it work?

19 A patient s story in the hospital Procedure of hip replacement Administration of high risk medication Administration of medication

20 Patient in surgery, OR Versie 1

21 Registration in Electronic Medical Record (EMR) Erik Zwarter, Information Manager at Erasmus MC Scan 1. Implant Id 2. Care Provider Id 3. Patient Id Activate UBP

22 Show in Electronic Medical Record (EMR)

23 Patient in surgery, OR, Inventory management Plaat wordt vervangen door andere

24 Hans Punt, CEO at Repoint Inventory Management 1 Logistics of implants from ordering to usage based on GS1 and location Process approach, combine implant with special implant instruments (=value) Interface EMR based on HL7 and/or FHIR Through CureTrack per OR complete logistics transparent and optimised Reusable equipment and consumables, RTLS or GS1 All equipment connected to EMR (patient) by simple cluster scan Set up all equipment before operation based on planning Complete control of process and stock levels (huge reduction) More important all quality demands (sterile, hygiene, expiration date) 100% compliant

25 Inventory Management 2 Every item has it s own webpage with details and statusses Status is automatically managed through CureTrack

26 Inventory Management 3 Every item is shown on a management page with department/room level accuracy

27 Final Inventory Management 4 CureTrack makes per OR all logistics transparent and optimized Reusable equipment and consumables, RTLS or GS1 All equipment can be connected to EMR (patient) by simple cluster scan All equipment technical and hygiene status real time monitoring/proces Possible to set up all equipment before operation based on planning Complete control of process and stock levels (huge reduction) More important all quality demands (sterile, hygiene, expiration date) 100% compliant

28 Patient in surgery, OR, Registries Plaat wordt vervangen door andere

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30 Dutch Artroplasty Register April 17, 2018 Chris van der Togt managing director LROI

31 What is the LROI? 1. An arthroplasty registry % of the hospitals in the Netherlands participate 3. Completeness: 99% hip, 99% knee, 94% shoulder, 92% ankle and 88% elbow

32 Why do we register? 1. Insight in patient related outcomes, and quality of care for all joint implants used in the Netherlands 2. Traceability of joint implants

33 How/what do we register? (patient, procedure, implant characteristics)

34 Result 1: Signal poor performing implants

35 Result 2: Feedback on the performance Poor performing hospital = outlier

36 In conclusion The LROI is a successful registry Barcode scanning is an important instrument: Reduction of errors in registration Not so time consuming This is very profitable for the patient safety and quality of care.

37 Patient in surgery, OR, high risk medication

38 Hans Pannekoek, Consultant

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41 High Risk Medication label with GS1 Barcode

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43 Medication Administration at the ward

44 Verification of from home medication during hospitalization, Remco Wijngaarden, Deployment manager at Medeye Myco 2 barcodes MedEye

45 Verification of from home medication during hospitalization Trend in Dutch hospitals Preferably use the same chronic medication as at home Hospital pharmacist is responsible for all medications administered in the hospital Medications from home are not checked by the hospital pharmacy: Not checked on right medication Not checked on expiration date

46 Step 1: Verify the patient by scanning the barcode on the patient wristband with the Myco 2

47 Step 2: MedEye bedside verification

48 Step 2a: Verification of from home medication by scanning the barcode (GS1) with the Myco 2

49 Step 2b: Verification done (administered and registered)

50 Performed checks in MedEye after scanning GS1 barcode Correct GS1 barcode: legal medication Medication is the same as ordered Medication did not pass expiration date

51 Wrap up 1 1. Uniform barcodes support safer medication administration and better traceability of medical devices like implants 2. Beneficial to: Healthcare professional Patient IT-vendor Government

52 Wrap up 2 3. Joint use of international standards IHE, HL7 and GS1 leads to: Scalable solutions (local, regional, national and international, institutional and home care) Ability for IT-vendors to link their systems Sustainable exchange of information Speed up implementation Flawless information exchange: safer processes.

53 Next Steps Get more parties involved: hospitals, IT-vendors Create awareness on national and international level Encourage hospitals to demand the use of UBP in their IT-systems Be the 28th IHE profile endorsed by the EU Commission

54 Contact: Thank you!

55 Changing the Way Healthcare CONNECTS