Are Medication Management Systems The Answer to Medication Error Prevention?
December 14, 2018 | by Brian Shoenfeld
The Medication Management System Market
The Joint Commission of Pharmacy Practitioners defines Medication Management Services as “a spectrum of patient-centered, pharmacist-provided, collaborative services that focus on medication appropriateness, effectiveness, safety, and adherence with the goal of improving health outcomes. While this definition is broad, it does include “safe and accurate provision of medications, medication access services, and medication administration services.”
The medication management systems market is expected to grow at a CAGR of 15.01 percent. The ultimate driver for this growth is the increasing legal liabilities associated with medication errors. Healthcare facilities are more motivated than ever to do what they can to protect their patients and improve patient outcomes. Medication management systems are a step in the right direction.
The Value of a Medication Management System
Hospitals and pharmacies are the primary end users of medication management systems. Medications and medical supplies are one of the highest cost items in a hospital. Controlling medication access and dispensing is key. One way to reduce medication errors is to bring the pharmacy to the bedside. Point-of-care medication dispensing reduces the number of touches and decreases the risk for a patient receiving the wrong medications.
According to the Journal of Patient Safety, 440,000 people die every year because of preventable medical errors. A 2016 study found that medical errors are the third leading cause of death in the United States, just behind heart disease and cancer. There are approximately two million adverse drug events in the United States every year, leading to 100,000 deaths and an increase in healthcare costs by nearly $140 billion.
Any reduction of risk can only serve to improve patient outcomes and hospital reputations while lowering costs and liabilities. Healthcare facilities differ in how they address medication management, however, it almost always involves changes in equipment, processes, and workflows.
Medication Errors Add Up
Medication errors come in all shapes and sizes, involving staff members from several disciplines. Doctors can mis-prescribe medications, pharmacists may fill the prescription with the wrong medication, nurses have been known to administer a drug that looks or sounds like the right drug but it isn’t. Errors like these cause everything from nausea to death. Few caregivers intentionally harm patients. While medical professionals are ethically and legally bound to a standard of care, mistakes happen. Things are missed. Corners are cut. Even with strict protocols in place, hospital staff are human and they can deviate from that standard. In legal terms, this is referred to as medical negligence.
Medical negligence is serious, even deadly. In one case at a North Carolina VA hospital, a patient was prescribed 1mg of a powerful opiate every four hours to control pain but was somehow given 4mg of the strong drug on two different occasions. The patient experienced cardiac arrest and died just hours later. The U.S. Department of Treasury has spent more than half a billion dollars on nearly 2,500 malpractice settlements on behalf of North and South Carolinas’ VA hospitals. VA hospitals aren’t alone.
In 2017, three patients at Boston’s Children’s Hospital suffered from medication errors resulting in one patient death and two near-death events. In the former case, a nurse administered a prescribed antibiotic 14 hours after it was supposed to be given, enabling the patient’s infection to spread rapidly. The internet is littered with such stories and there are countless medical malpractice law firms standing by to help victims and their families get justice.
These cases may not be the norm, but they are all too common. Hospital reputations suffer, healthcare professionals often lose their licenses, and countless dollars are lost in the aftermath. It’s an ugly side of an industry in which we all put so much faith. Hospitals understand their responsibility and, therefore, implement a medication management system to thwart medication errors.
What’s Involved in a Medication Management System?
A medication management system includes everything from establishing and enforcing strict protocols to investing in equipment and technology that empowers doctors, pharmacists, and nurses to deliver a standard of care. A medication management system is an attempt to solve a complex problem by integrating multiple elements. Clearly, a piece of software won’t be effective unless it is used properly and as designed. A medication alert system will only be of value if a nurse doesn’t override it. These are just examples, however, best practice protocols are foundational.
A medication management system is as much about the people as it is the tools they have at their disposal. A medication management system likely includes medication cabinets (or medcabs) and medication carts (medcarts). These cabinets and carts enable the closed-door pharmacy, located within a hospital and serving only admitted hospital patients, the ability to retain greater control over the medications it sends out to patients. Instead of many medications being stored in bulk centrally in medication rooms, the pharmacy technician can pre-dispense each medication per patient and store them in a locked bin on a medication cart or in the patient room in a medication cabinet.
Bulk medications are costly to maintain and inevitably result in waste. Hospitals must keep these medications inventoried yet when they are misused or squandered, they often lead to drug shortages. It is common for nurses to go to retrieve a bulk medication, only to find it wasn’t properly restocked. They then must send a rush order to the pharmacy. In order to fill the prescription, the pharmacist has to stop in the middle of his or her workflow to fill the order. This doesn’t always happen. Nurses then wait on the pharmacy, causing the patient to have to wait as well. In lieu of waiting, nurses have been known to access other floors’ bulk medications or find an alternative medication. This presents patient risk and further depletes inventory.
As part of a modern medication management system, the medcabs and medcarts often include embedded technology. Equipped with innovative software, these medication cabinets and carts manage and track access. Digital locking devices ensure only authorized personnel are accessing each patient’s medications and that the patient is receiving the correct medication and dosage. The smart software provides healthcare professionals and auditors an easy “paper trail” as to where medications went and who accessed them. This can be an excellent deterrent for medication diversion. It also enables nursing and pharmacy to work more efficiently and confidently.
Many medication management systems are integrated with the electronic health record system (EHS) to reduce the amount of paperwork and redundant workflows. They can also be integrated with pharmacy systems. These key integrations make it possible for the doctors, pharmacists, and nurses to all be on the same page in how best to care for each patient. Prescribed medications can be cross-checked with the patient’s current medications to determine any potential drug interactions. If the patient is allergic to a medication, the pharmacist can serve as a second set of eyes if the doctor somehow missed the alert when he prescribed. It can also simplify billing so patients only pay for what was actually prescribed.
Automation is key in a medication management system. Automation not only improves efficiencies and patient outcomes, but it reduces costs and risk as well. It’s this balance between patient care and economics that is often so challenging for hospitals, but it is the key to success. According to Hospital Pharmacy Europe, “The main task of the medication management system today is to combine the highest quality and safety care for the patient with maximum economy. The provision of the right medication at the right time in the right place calls for a multi-step operation in which workers with differing education and qualifications are responsible for individual steps in the process.”
As more technologies evolve and are integrated, healthcare facilities will have to decide whether the economics of it all is feasible. When human lives are at stake, it seems obvious that no investment is too much. Even so, hospitals don’t have an unending stockpile of cash at their disposal. Hard decisions must be made as to where available and committed funds should be allocated. This won’t be an easy task as costs in other areas continue to rise and compete for dollars.
A medication management system addresses multiple issues, however. It enables nurses to spend more quality time with patients, caring for them rather than retrieving medications. It reduces the burden on nurses to retrieve the right medications per patient. It gives pharmacies more control over medications and dispensing. It improves workflow efficiency and provides checks and balances for optimal safety. It gives patients and their loved ones peace of mind.
About the Author
Brian joined Talon in 2014 and brought with him a proven track record for project managing, product development, and increasing operational efficiency. Using his knowledge of STEM, business prowess, and healthcare experience, Brian leads Talon’s operational improvements to create better products and improved customer service. When he’s not in the office, Brian spends time with his wife and two sons and cheers on Syracuse.