IHE PharmacyHosiptal admission & discharge

Michael TanProduct manager

19 march 2013

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Topics• Workflow of hospital admission &

discharge

• Focus on transfer point between external and internal processes

• Internal hospital flow not in scope

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Actors• Hospital • Pharmacists, physicians

• Community pharmacies

• General practicionars

• Other institutions such as nursing homes, mental hospitals

• Other hospital pharmacies

• Drug information systems

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Workflow Admission• Patient being admitted in hospital for treatment ( operation).

• Intake consult. Interview with pharmacist or physician.

• Review process of medication profile:• Collect information from other systems ( pharmacies, GP, DIS, Repository).

• Patient has an existing medication profile on paper

• Patient has taken a bag of pills along

• Care provider reviews and reconciles the various inputs, resulting in a current medication status. This is registered into the EHR of the hospital.

• Care provider makes decisions for new medication therapy:• Medication is continued: same brand under new prescriber. Same dosage.

• Medication is altered: new prescription with other brand or dosage.

• Medication is stopped:

• In Netherlands hospitals medication is included in the costs and new prescriptions are mandatory.

• The other actors (prescribers, pharmacists) are informed of the altered/ terminated prescriptions.

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Flow

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Workflow discharge• Patient has an exit consult with prescriber.

• Care provider reviews the last medication profile from the hospital EHR.

• Prescriber sets up a new medication therapy:• Collect the information from the EHR and the status before admission

( including the stopped therapies).

• The hospital prescriptions are stopped.

• New prescriptions are made for the ambulatory setting.

• The prescriptions are sent to community pharmacy.

• Some discontinued medication from the period before admission are reinstated.

• Others are permanently stopped ( not reinstated).

• The other care providers are informed: either with a medication profile (digital/print out) or copies of the prescriptions are sent to other care providers.

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Exit flow

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Vragen

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Michael TanProduct manager

www.nictiz.nl