CSC's Medication Management (MedChart) solution replaces paper medication charts in acute hospitals, aged care facilities and community health centres. Fully web based, the solution is easy to deploy and includes electronic prescribing, pharmacy review, drug administration and clinical decision support.

Proven to reduce medication errors (Westbrook, 2012), CSC Medication Management supports clinical workflows. Instead of adding to staff workload, the solution reduces effort and confusion, enables greater coordination and most importantly – provides an accessible, definitive and clear picture of a patient’s medications.

Published peer reviewed papers featuring MedChart:

Effects of Two Commercial Electronic Prescribing Systems on Prescribing Error Rates in Hospital In-Patients: A Before and After Study
Westbrook JI, Reckmann M, Li L, Runciman WB, Burke R, et al. (2012). PLoS Med 9(1): e1001164. doi:10.1371/journal.pmed.1001164

Implementing Electronic Medication Management at an Australian Teaching Hospital
Day RO, Roffe, DJ, Richardson KL, Baysari MT, Brennan NJ, Beveridge S, Melocco T, Ainge J, Westbrook JI. Med J Aust 2011; 195 (9): 498-502. doi: 10.5694/mja11.10451

Key Benefits

• Eliminates paper chart based errors and reduces mediation error (for more, see the Lessons from a Dunedin Pilot Webinar)
• Provides appropriate prescribing support to junior doctors, specialists and senior consultants
• Increases pharmacy involvement in clinical care and facilitates pharmacy review
• Increases ability of nurses to coordinate and share responsibilities
• Supports accurate and efficient drug administration
• Improves communication between nursing, medical and pharmacy staff
• Supports clinical workflows to reduce rather than add to staff workload
• Configurable to include detailed protocols to support quality use of medications such as antibiotics, anticoagulants and others
• Integration: CSC Medication Management is designed to integrate seamlessly with clinical information systems.
  

Variable dose medications are easy to enter and manage

The Imperative to Improve Medication Safety
Medication error is a significant problem that causes a great deal of preventable harm. Australian hospital research shows that nearly 30% of hospital reported adverse events are medication related and that adverse drug events are reported in 1% of hospital admissions (Runciman, 2003). According to US researchers, medication errors occur at a rate of 5 percent per 100 medication orders (Bates, 1995). The US Institute of Medicine estimates that for every day in hospital, a patient will experience a medication error.

Proven to Reduce Medication Error
Proven to reduce medication errors (Westbrook, 2010), CSC Medication Management helped staff at St.Vincent’s Hospital Sydney to reduce prescribing errors by more than 50% and to eliminate incomplete and unclear orders.

The clinician designed interface supports clinical workflows to provide relevant and useful information at the point of need.  Instead of adding to staff workload, CSC Medication Management reduces effort and confusion, enables greater coordination and most importantly – provides an accessible, definitive and clear picture of a patient’s medications.

Our Medication Management solution streamlines the medication prescribing, pharmacy review and administration processes to reduce risk, harm, confusion, error and inefficiency and improve coordination between clinical staff.

Electronic Medication Chart
At the heart of the CSC Medication Management solution, is an electronic medication chart. This electronic medication chart eliminates problems pervasive in paper charts such as; illegible handwriting, dangerous use of abbreviations, missing information, incorrect ceasing and PRN medications that exceed maximums. Chart transcription errors are eliminated, and access is improved with clinical staff able to view and update a patient’s chart from any terminal.

Electronic Prescribing
CSC’s Medication Management solution includes features that improve prescribing accuracy and efficiency. For example, the drug selection list can be configured to allow selection of nationally or hospital formulary available medications. The variable dose function is particularly useful for managing warfarin orders against an INR range. To improve dose calculations, prescribers are prompted to enter weight.

Administration
The administration screen is designed to prevent administration of non-scheduled medications. Using a work list, nurses are able to work methodically and reliably identify both medications and patients. In the case of long stay or aged care residents, a photograph can be included.

Pharmacy Review
Pharmacists have an essential role to play in improving medication safety in hospitals and in aged care. With CSC Medication Management, pharmacy involvement in clinical care is enhanced, and pharmacy review is facilitated via remote chart access. Instead of searching for paper medication charts or deciphering illegible handwriting, pharmacists are available to provide expertise to both prescribing doctors and administering nurses and to spend time on patient care.

Decision Support
74% of medication errors occur at the prescribing stage (Kaushal, 2001) and 2.4% of prescriptions have the potential to cause an adverse drug event (Runciman, 2003). Prescribing is an error prone activity, and junior doctors in particular need support.

CSC’s configurable clinical decision support provides appropriate prescribing support for junior doctors, specialists and senior consultants, and avoids alert fatigue. Instead of a one-size-fits-all approach, decision support can be configured to provide extensive support for junior doctors and a limited alert set that excludes cardiac drugs for a cardiologist.

Alerts include:

• Drug to allergy and intolerance warnings 
• Drug to drug interactions 
• Therapeutic duplication 
• Pregnancy warnings 
• Wrong dose - high, low and cumulative 
• Abnormal organ function requiring changes to dosage 
• Changing serum drug levels 
• Late or missed medications 
• Disease specific protocols 
• Restricted formulary lists 
• Locally defined clinical and business rules

Reference Viewer
Use the inbuilt Reference Viewer to integrate reference data from multiple sources for quick reference during prescribing.

Data sources can include:

• Generic drug monographs and class information provided by the Australian Medicines Handbook
• Brand prescribing information sourced from MIMS, including consumer medicine information
• Best practice guidelines sourced from the Therapeutic Guidelines
• The Melbourne Royal Children’s Hospital Paediatric Pharmacopeia
• Locally developed guidelines, e.g. septicaemia, warfarin, oncology and antibiotic prescribing protocols

Nursing Summary Screen
Usually on a screen in the nursing station, the unique nurse summary screen provides an overview of medication related tasks. At a glance nursing staff can see medications due or overdue. Instead of working in isolation, nurses can work as a team to provide quality care and efficiently share the workload.
 
Offline Chart Backup Facility
Our Offline Chart Backup Facility ensures that your information is available at all times, even during a system outage. A real time duplication of a patient’s most recent medication chart is always maintained on a designated computer in the system. In the case of a system failure, you have the ability to print charts and continue medication management manually until system access is re-established.

The Technology
Our web based architecture means there is no requirement for any of the application software to be installed on your users’ computers. Our software is run from a central server and is accessed using Internet Explorer. This makes it:-

• Easy to install
• Simple to deploy
• Straightforward to maintain
• Capable of running in installations ranging from small clinics, through regional or state based health institutions to a full national shared electronic health record system

References:
Westbrook J, Lo C, Reckmann M, Runciman WB, Braithwaite J, Day R. The effectiveness of an electronic medication management system to reduce prescribing errors in hospital. 18th Annual Health Informatics Conference. August 2010.
Runciman, WB et al. Adverse drug events and medication errors in Australia. Int J Qual Health Care 2003;15: i49-i59.
Kaushal R, Bates DW et al. Medication errors and adverse drug events in pediatric patients. JAMA. 2001;285:2114-2120.