Electronic medication management is becoming increasingly embedded in our health system and has already had a meaningful impact on prescribing decisions, safety, workflow efficiencies, quality assurance and audit capacity.
Whilst there is growing consensus that the advent of digital platforms in medical practice is a positive development for the sector, it does raise a number of important challenges – particularly in the context of medicines safety.
It is estimated 250,000 medication-related hospital admissions occur each year in Australia. Aside from the human costs involved, these admissions equate to an estimated tax payer spend of $1.4 billion annually.
Though digital health technologies are expected to reduce these figures, the overall system will need further refinement in order to make maximum inroads. As such, digital health is currently a key focus of Commonwealth, state and territory governments of Australia.
Andrew Matthews is the Director of the Medicines Safety Program at the Australian Digital Health Agency – an organisation playing a key role in this push. The Agency in consultation with stakeholders are currently finalising the production of a national digital medicines blueprint.
Through initiatives like Electronic Prescriptions and Pharmacist Shared Medicines Lists (PSML) the blueprint will aim to provide tangible improvements in patient protection in terms of medicine related harm.
Matthews says this initiative will have two main safety priorities.
#1 – Integration and interoperability
Health innovation is occurring at an impressive rate – a key advantage being continual disruption of the (typically) more drawn-out, cumbersome, or error-prone manual methods of service delivery.
However, a concern is the lack of communication these systems tend to have with one another.
“At the moment our system is still quite fragmented. We know that practitioners need systems to better talk with one another to achieve maximum patient outcomes.
“Having to log in and out frequently of different systems – which deal respectively with areas like pathology, diagnostic imaging, dispensing and electronic medical record systems – is robbing staff of the efficiency gains these systems have the potential to deliver,” said Matthews.
Additionally, having data spread out across multiple systems leaves greater scope for human error than would be the case with a more homogenised system.
“Integrating patient records and having all data accessible via a central point of care is vital in the context of medicines safety,” he added.
According to Matthews, the issues of usability are two-fold.
“Firstly, staff need to be able to use machines comfortably in a way which doesn’t interfere with their clinical workflows. And secondly, patients need to have sufficient health literacy to navigate the systems on their end.”
Matthews says the Agency, health departments and peak bodies that represent healthcare providers are all focused on addressing this.
“We know from data from the Australian Commission on Safety and Quality in Health Care that 60 percent of consumers don’t have sufficient health literacy to navigate through the complexities of the health system. The question is, will adding a digital component help or hinder this?
“We need to make sure that digital health systems improve patients’ access to medicines and health information.”
Often, he says, a system’s usability relates to its interoperability. But factors like low technical literacy among staff also come into play. Sometimes it may simply be down to a badly-engineered interface.
“Our blueprint and also the Agency’s work developing a National Digital Health Workforce and Education Roadmap aims to address these issues and make digital health systems second nature to everyone in the health care workforce – including the sector’s strongest technophobes,” said Matthews.
“We have already seen this occur with mainstream technologies like PCs and mobile phones so we certainly know it’s possible.”
Presenting at the eMedication Management Conference – 5-6 March 2020, Andrew Matthews will talk more about the Australian Digital Health Agency’s safety push – including an insight into his ongoing consultations with frontline workers.