I N N O V A T I O N A N D V A L U E T H R O U G H S E C U R E T E C H N O L O G Y P H A R M A C Y I N F O R M A T I O N S Y S T E M

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1 I N N O V A T I O N A N D V A L U E T H R O U G H S E C U R E T E C H N O L O G Y P H A R M A C Y I N F O R M A T I O N S Y S T E M D a t e 2 9 / 0 5 / 2 5

2 History Dominion has worked exclusively for over 7 years on the development of solutions for the healthcare sector. We are present in a number of continents and follow an ongoing process of evolution and adaptation. 2

3 H I S T O R Y > Different versions of FarmaTools have been installed in: Mexico Portugal Honduras Argentina Chile Spain 3

4 Characteristics Structure of FarmaTools: > PHIS > Administrative modules. > Clinical modules. > Masters module. > Scalable and parametrical system. Long experience in communication with: > Information Systems CLINICAL STUDIES ERP LABORATORIES > Automatic mechanisms: Automated systems for dispensation to patients. Vertical automatic systems. Horizontal automatic systems. Robots for the manufacture of mixes. Implemented in 8% of public hospitals in Spain: e.g. Hospital La Paz de Madrid (33 beds), Hospital Puerta del Hierro (63 beds) and Hospital Reina Sofía (39 beds, five centers). 4

5 F A R M A T O O L S I N F I G U R E S More than 3.5 million barcode lines Farmatools is an extensive and complex functional system. 50 new functionalities per year Constant growth for the sector s growing needs. Modules for different types of devices have been created The latest modules created are oriented towards mobility inside hospitals. 5

6 F A R M A T O O L S I N F I G U R E S Pharmaceutical expenditure is the highest item after payroll expenses The system allows the dispensing of more than one million drugs per day Around 3,00 healthcare professionals enter FarmaTools every day The entire budget is managed from pharmacy systems. To do this, the system manages around 450,000 pharmacological and nonpharmacological prescriptions per day. Pharmacists, administrative personnel, doctors, nurses or managers use our solution on a daily basis. 6

7 Main administrative modules 7

8 F A R M A T O O L S M O D U L E S Main administrative modules Financial management Analytical management (statistics and reports) Management of the system (user profiles and permits) 8

9 F A R M A T O O L S M O D U L E S > F I N A N C I A L M A N A G E M E N T Financial management Managing tenders Automation and messaging > Inventory control - always in real time. > Automated purchasing based on the level of consumption. > Control of expiry dates, loans, dispensations, regularizaciones, reenvasados. FarmaTools enables you to monitor published tenders, keeping you up to date on their status or completion. The system communications with different automated systems and allows the identification of drugs and inputs by barcodes. Orders are sent by fax or EDI messaging. 9

10 F A R M A T O O L S M O D U L E S > A D M I N S I T R A T I V E M A N A G E M E N T Analytic management (Statistics, Reports) Comparative and evolutionary reports. Seeking to reduce administrative tasks. Depending on the user s needs. Management of the system > Control of authorized users. >Definition of profiles, keys that can be used, menu options etc. > Complete traceability of all actions. Volume Supplies medication to around 600,000 patients per day. Calculates and optimizes the management of more than 375,000 products per day. 0

11 F A R M A T O O L S M O D U L E S I I Pharmaceutical validation Our vision. In 2004 the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) approved the MM.4.0 standard on the validation of pharmaceutical treatments, establishing that: Pharmacists should review all medication orders before they are dispensed or taken from stock, an automated cabinet or other distribution system. Management of ambulatory patients Centralized mixtures unit Centralized article master files and inputs Day hospital (dialysis, onco) Standard dose hospitals and A&E

12 F A R M A T O O L S M O D U L E S > C L I N I C A L M O D U L E S Hospitalization and Emergency Units > Assisted electronic prescription. > Calculation of doses based on results of analyses. > Assisted validation, communication between doctor and pharmacist > Pharmacovigilance. Administration Alert in all modules due to Interactions, Theratogenies, Allergies, overdosing, Crossed allergies, Duplicated treatment, Kidney failure, liver/kidney failure, rules depending on analytical results Outpatients > Forecast of number of patients attending hospital, necessary medication and patient agenda. > Calculation of therapeutical compliance. > Supervision and monitoring of the patient. 2

13 F A R M A T O O L S M O D U L E S > C L I N I C A L M O D U L E S Oncology patients and day hospital > Protocols for prescription associated to the diagnosis. > Management of chemotherapy cycles and adverse effects. > Support to doctors and pharmacists in decision-making: control of correct dosage, impact with analytical results, calculation on the basis of weight, Surface area, AUC Safe administration modules for patients at the bedside The system enables the clear identification of the patient and his/her treatment, validating what is correct and recording incidents. > Centralized master file of drugs and inputs. 3

14 F A R M A T O O L S M O D U L E S > C L I N I C A L M O D U L E S Ongoing search for zero errors in medication Not achieved yet, but the number of PRMs solved with FT is increasing every day. Validation = giving the patient security The system means that the patient s pharmacological profile of the patient in an agile way the day before dispensation. The objective is not providing 00%. We need to gain time for investigation. Continuing to reduce costs Not just based on improving processes and reducing adverse effects. Also seeking the analysis of treatments and generating statistical processes for the efficient use of drugs. 4

15 A S S I S T E D E L E C T R O N I C P R E S C R I P T I O N 5

16 A S S I S T E D V A L I D A T I O N O F T R E A T M E N T S Interactions ACENOCUMAROL with ACETILSALICILICO ACIDO (leads to vomiting of plasma density). - Description: The following drugs boost anticoagulation and/or change hemostasis, therefore increasing the risk of hemorrhage: Heparin platelet inhibition aggregators such as clopidogrel or salicylic acid or derivates (e.g. acetylsalicylic acid, para-aminosalicylic acid, diflunisal), Phenylbutazone or other pyrazolone derivates (e.g.. Sulfinpyrazone), other non-steroid anti-inflammatory drugs including cyclo-oxygenase 2 inhibitors (e.g. Celecoxib), high doses methylprednisolone by IV. We do not recommend the use of Sintrom with these drugs. When Sintrom is combined with these drugs, coagulation tests should be done at a higher frequency. - Significance: High 6

17 T R A T A M I E N T O S O N C O L Ó G I C O S Y M E Z C L A S 7

18 Sending data on patients, admissions, discharges, etc. Sending analyses Oncological treatments and mixtures Enterprise Application Integration Electronic Prescription Enterprise Application Integration Modification/Validation by Pharmacy Dispensing Cabinets on hospital floors Horizontal carousel cabinets Vertical carousel cabinets 8

19 Saving Lives, Saving money 9

20 A S P E C T O E C O N Ó M I C O D E L A S H E R R A M I E N T A S P H I S The imperative for computerized Physician Order Entry in Massachusetts Hospitals Our estimate of preventable adverse drug event rates of 0.4 percent and potential annual savings of $2.7 million per hospital are conservative. If CPOE systems were fully implemented in the 63 Massachussetts hospitals technology, the number of adverse drug events prevented every year could be approximately million annually. All Massachussetts hospitals should complete full implementation of CPOE systems, including comprehensive clinical decision support, within the four year period

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