Asia Pacific Electronic Health Records Conference 2019 16-19 October, 2019 Convention Centre 3, Hong Kong Science Park, Shatin, New Territories, Hong Kong Meaningful Use of Electronic Health Record Sharing System (eHRSS) Allergy Record to Enhance Medication Safety in Private Healthcare Sectors in Hong Kong Lau Connie Shuk Man 1 , Wong ACK 1 , Ma MKM 2 , Chan MKF 2 , Tong ELH 1 , Chan HKC 2 , Wong WN 1 1 Health Informatics Department, Information Technology and Health Informatics Division, Head Office, Hospital Authority, HKSAR 2 Information Technology Department, Information Technology and Health Informatics Division, Head Office, Hospital Authority, HKSAR
Drug Allergy Allergic reactions to drugs can result in serious and life-threatening consequences. 12% Medication error due to lack of understanding of drug allergies 1 8-13% Medication errors preventable if allergy documented at the time of prescribing 2 Drug allergy information is important. 1. Lesar TS, Briceland L, Stein DS. Factors related to errors in medication prescribing. JAMA 1997;277:312 – 17. 2 2. Kuperman GJ, Marston E, Paterno M, et al. Creating an enterprise-wide allergy repository at Partners HealthCare System. AMIA Annu Symp Proc 2003:376 – 80.
Medication Decision Support Indication Side effects Allergy profile 56% Reduction in Contraindications medication errors Treatment due to known allergies after implementing computerised duration provider order entry with clinical Dosage decision support (CDS) of allergy alerts 3 Dosing Frequency 3. Bates DW, Leape LL, Cullen DJ, et al. Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA 1998;280:1311 – 16.
Components of a Drug Allergy Checking System 2 1 Medication orders Patient’s allergy profile (e.g. CPOE applications) 3 Drug allergy checking system (knowledge-based of semantic links between ingredients)
Gap of a effective Drug Allergy Checking System 1 2 How to acquire a complete allergy Medication orders Patient’s allergy profile (e.g. CPOE applications) profile for an effective Complete Accurate drug allergy checking Updated system? Allergy Profile 3 Drug allergy checking system (knowledge-based of semantic eHRSS is filling links between ingredients) the Gap.
CMS On-ramp CMS Adaptation Local eMR Viewer HA CMS CMS Adaptation
eHR Viewer
CMS On-ramp CMS Adaptation Local eMR How can I share allergy records if I don’t have a Viewer local eMR in my clinic?? HA CMS No local electronic medical record (eMR) System CMS Adaptation
2 1 Input details and [Save] Search by keyword
Built-in-smart search Efficient documentation Able to update and delete Record reflected in eHR Viewer immediately
284 Cumulative access 38 100 + HCPs records created created records May 2019 Today Mar 2016 Oct 2018
Gap of a effective Drug Allergy Checking System 1 2 How to make use of complete eHRSS Medication orders Patient’s allergy profile (e.g. CPOE applications) allergy profile in a Complete, accurate and update allergy profile Records in Records in drug allergy checking eHRSS local eMR system? 3 Drug allergy checking system (knowledge-based of semantic eHRSS is filling links between ingredients) the Gap.
Local medical + record system (eMR) Allergy & ADR = Structured Alert Adaptation Module (SAAM) with allergy download function
Data Quality of eHRSS allergy records Conclusion Allergy & ADR Record in eHR Viewer Allergy record distribution 13% 197,389 Rea ead an and rec ecognized by y 72% Allergy records in eHRSS system dir directly ly 87% No Allergy record Allergy records are structured Have Allergy record and encoded Statistics as of June 2018
Structured Alert Adaptation Medication Order Entry Module (SAAM) Module (MOE) Point to note Non-structured record (28%) are not covered. Automated Measures have to be considered for a clear Drug allergy checking system checking scope to users.
Conclusion: Meaningful Use of Allergy Record Conclusion Meaningful use of data Apply in Medication Decision Support Meaningful use of data Access to the Allergy Download shared record eHR Sharing Data sharing in eHRSS System Directly input allergy Structural documentation records in eHR Viewer of Allergy record
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