Electronic medication management systems improve safety, efficiency and quality

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Medication errors remain the second most common type of medical incident reported in Australian hospitals and, of all medication errors, omission or overdose of medicines occurs most frequently. Reducing all errors will significantly improve patient safety and the quality use of medicines. 

Traditional systems force staff to spend valuable time searching through paper-based records when determining what medications are due throughout any given medication round. This process is not only lengthy, but can easily increase the opportunity for discrepancies and errors.

Increasingly hospitals and regional health services are turning to digital systems as a solution. An electronic medication management (EMM) system supports the improved quality, safety and effectiveness of medication management within hospitals. This includes providing support for doctors, nurses and pharmacists to digitally prescribe, order, check, reconcile, dispense and record the administration of medicines. EMM covers the entire hospital medication cycle including prescribing by doctors, review and dispensing of medication orders by pharmacists, and administration of medicines by nurses. 

EMM can apply to:

  • Prescribing systems, such as general practitioner desktop systems or hospital clinical information systems that have electronic ordering
  • Decision support systems, such as evidence-based order sets, allergy checking and medicine interactions
  • Dispensing systems, such as pharmacy software and automated dispensing systems
  • Ordering and supply solutions, such as the electronic transfer of prescriptions (ETP) and inventory solutions
  • Electronic medical records

Traditional medication administration processes often requires nurses to administer hundreds of daily medications for patients. However, EMM reduces that pressure on nurses by providing a common electronic record that can be accessed by all authorised staff within the hospital. EMM reduces medication errors through improved prescription legibility, dose calculation and clinical decision support. By using EMM, hospitals can reduce the number of preventable adverse medication events, and medication prescribing and dispensing errors. EMM systems can improve the accuracy and visibility of medical information, so that the communication between clinicians, and with patients, is clearer. It enables best practice information to be more readily available to prescribers and improves linkages between clinical information systems. 

It can also improve hospital-wide efficiency in the medication management process, such as reducing the time required to locate paper medication charts or to supply non-imprest medicines. 
Medication management is a complex area involving many functional areas within a healthcare organisation, and having an electronic system in itself does not guarantee good practice, or that all the expected benefits will be achieved. EMM systems can reduce medication errors, but they also have the potential to adversely affect safety and quality of care if the system is poorly designed and implemented, and under-resourced. This risk is highlighted in a number of studies that show increased medication errors following poorly planned implementations of EMM systems. With many Australian hospitals planning to implement EMM systems, it is essential that this risk is minimised by considering the international literature and learning from the experiences of early Australian EMM system implementations.

Implementing an EMM system within a hospital is a major transformational project that substantially affects clinical service delivery, hospital departments and the work of clinicians. It requires extensive pre-implementation planning, including initial scoping, developing a business case, evaluating and selecting an EMM system product, and conducting a detailed implementation planning study. It is essential that the project is adequately resourced, that change is managed effectively, and that the project has the endorsement and full support of the hospital executive and senior clinical staff.

“Electronic Medication Management Systems — A Guide to Safe Implementation (2nd edition)”  has recently been produced by the Australian Commission on Safety and Quality in Health Care  and the Australian Digital Health Agency to assist hospitals to safely implement EMM systems. The guide has been informed by a review of international literature, the experiences of previous Australian EMM system implementation sites and extensive stakeholder consultation to provide guidance on the activities required for a safe and effective EMM system implementation.

Find more information resources about EMM on CKN