Drug Information System

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1 Drug Information System Nurse Practitioners Overview September 14, 2015

2 Topics Drug Information System Overview DIS Portal Demo Rollout Approach Timing

3 What is the Drug Information System

4 Nova Scotia s Drug Information System (DIS) Objective: To ensure patient safety by reducing and/or eliminating adverse events caused by drug-to-drug interactions, drug/disease contraindications, duplicate therapies and certain types of medication errors. The DIS: Facilitates secure electronic exchange of medication information; Allows healthcare providers to complete drug utilization reviews and assess contraindications, potential medication conflicts, medication allergies and adverse reactions to medications; Supports safe and appropriate drug therapy and reduces the incidence and severity of medication-related issues; Supports existing Medication Reconciliation processes; Enables the creation of electronic prescriptions (e-prescribing); and Provides healthcare professionals with access to drug information reference material.

5 Patient Care Benefits One patient medication profile that captures all community pharmacy medications orders and dispenses Enables health care professionals to more efficiently share information on medication history and prescriptions Reduce errors and duplication with prescribing Manage and reconcile medication orders through the DIS by health care providers e-prescribing will reduce time spent clarifying illegible prescriptions and reduce errors due to illegible prescriptions All contribute to improved patient care

6 DIS Practice Model the future Contributing and Consuming Patient Medication Information Hospital Community Pharmacy Drug Information System Physician / Nurse Practitioner Patient Medication Profile Optometrist Midwife Dentist / Dental Hygienist

7 What is the Drug Information System (DIS) a provincial repository of patient medication information that completes the provincial electronic health record system (SHARE) contains a medication profile for every Nova Scotian (and others) who has a prescription filled in a community pharmacy that is connected to DIS SHARE SHARE Clinical Portal (Community Med Profile tab) DIS Drug Information System Portal Nova Scotia s Electronic Health Record

8 DIS Medication Profile The medication profile will automatically include: Prescriptions Dispensed by Community Pharmacies connected to the DIS e-prescribed Drugs & Devices If entered by a healthcare provider*, the medication profile may also include: Other Medications (e.g., OTCs, Drug Samples, Natural Products) Allergies & Intolerances Adverse Drug Reactions Immunizations Medical Conditions Patient Observations Patient Notes The profile will support existing Med Rec processes * Dispensary staff in community pharmacies and healthcare providers with access to the DIS Portal. Pharmacy Professional Services (e.g., smoking cessation) entered by community pharmacies only

9 Accessing the DIS Medication Profile healthcare providers will access the DIS through either the SHARE Clinical Portal or the DIS Portal... SHARE Clinical Portal Users will access the medication profile through a new tab called Community Med Profile Users will have view-only access to the medication profile Over time, all users with access to both lab and DI will have access to the medication profile as well DIS Portal This portal will allow users to add information to or update information in a patient s medication profile It will also enable the creation of electronic prescriptions (e-prescribe) This portal will be used primarily by prescribers.

10 User Access Community Users: (Private Healthcare Organizations - PHCO) User Group Users Portal Access Type Prescribers Non-Prescribers Physicians, Nurse Practitioners, Midwives, Dentists, Optometrists, Dental Hygienists Note #1: RNs, as appropriate, will also have access to the DIS Portal Note #2: Community pharmacists will e-prescribe through their pharmacy software SHARE users In Hospital Admin Staff (PHCO) Clinical Staff (PHCO) DIS Portal SHARE Clinical Portal Community Med Profile tab (i.e., DIS) only View, Add/Update, e- Prescribe View-Only ability to print patient specific reports for the prescribers

11 DIS Portal User Access Matrix - RN Profile Based on direction from the provincial VPs Clinical committee, a role profile for in-hospital Registered Nurses will be included in the DIS Portal User Access Matrix This role profile will allow in-hospital Registered Nurses to add information to and update existing information in a patient s DIS Medication Profile See the following slide for the types of information that can be added to/updated This role profile will be available to in-hospital Registered Nurses, at the Manager s discretion, in ambulatory care areas and clinics In-hospital Registered Nurses in acute in-patient care areas will not have access to this role profile view-only access to a patient s medication profile will be available to these registered nurses through the SHARE Clinical Portal

12 DIS Rollout Streams Stream 1 Connecting Community Pharmacies Dispensary staff access DIS through their pharmacy software Rollout start: November 2013 Rollout end: All community pharmacies must be connected by June 30, 2016 (217 September 2, 2015) Stream 2 Access in Hospital and in Community Healthcare providers access DIS through the DIS Portal or the SHARE Clinical Portal Rollout start: Fall 2015 Rollout end: Ongoing as healthcare providers request access Stream 3 Connecting with Physician EMRs Physicians and their staff access DIS through the Electronic Medical Record (EMR) system in the Physician s clinic Rollout start: Dependent on EMR vendors Rollout end: Ongoing as physician clinics request connection

13 Implementation Status Stream out of 307 pharmacies connected Stream 2 All pharmacies expected to connect by June 2016 Integrated with the SHARE Clinical Portal and available through a standalone DIS Portal Stream 3 Pilots starting September 2015 One EMR vendor has started development to integrate with the DIS targeting early 2016 for the first clinic to be live Two other vendors are in discussion about funding to support development costs

14 DIS Portal Demo

15 What is the Rollout Approach

16 Stream 2 - Rollout Approach Community and Hospital Users Phase 1 Pilots (Specific Communities & Users) Based on pharmacy connections Will include e-prescribing (timing to be determined) Identify potential in-community participants (PHCOs) with professional associations (e.g., DNS, NSDA) Work with Zones to identify specific hospital clinics/areas Phase 2 Targeted Communities Based on pharmacy connections Will include e-prescribing Available to all in-community users (PHCOs) Available to hospital users (clinics/area rollouts to be determined by each Zone) Work with professional associations and DHAs Phase 3 DIS available across Nova Scotia All pharmacies connected Will include e-prescribing DIS Available to all prescribers and non-prescribers Portal Available for full rollout in hospital (available to all SHARE users that will have DIS) Sep 2015 SHARE Clinical Portal (Community Med Profile tab)

17 Timing North End Community Clinic Aug 12 th DIS Portal access by 2 healthcare providers Dr. Rod Wilson and Keith Cockersell (Nurse Practitioner) Cheticamp/Inverness week of Sept 28 th Sacred Heart Hospital Emergency Department (including physicians) - Cheticamp Inverness Consolidated Memorial Hospital Inverness Emergency Department (including physicians) Pharmacy Department 2 Nurse Practitioners Starting in late Oct available in target communities Working with the Provincial Health Authority zone management to determine in-hospital rollout Working directly with private health care organizations with support from representative associations and colleges

18 novascotia.ca/dhw/dis

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