Concept 34 Low Resolution

Prescription Errors

A PresentationFor

Tim Delaney

byPhilip O’Donnell

What the patient expected

What the patient received

Let’s confuse the patient

Consequences• Medication cannot be re-used.• Patients may take the wrong medication.• Causing additional visits to the GP.• More trips to casualty • More pressure on hospital beds • Some patients die.

Why does this happen?GMS and LTI

Prescriptions are issued by:• Multiple GPs• Locums• Out of hours Doc• A & E Doctors• Multiple Consultants

Most Doctors and Pharmacies have computersYet we still use paper

Therefore we create human error

How do you solve this?

Use Cloud Technology

Reduce Human Error

Cloud Technology

Prescription Database

G.P. Pharmacy

Patient

Cloud Technology

Prescription Database

G.P.

Nursing Homes

A & E or Hospital

Pharmacy

H.S.E.

Patient

Out of hours Doc

1st Consultant

2nd Consultant

2nd Pharmacy

American View of Prescription

National Data Analysis Potential

• < 50% of chronic patients continue to take their medication.

• Incidences of illness by area

• Relative use of generic v Rx products.

• HSE purchasing power

• Feedback to doctors

• NCPE

• Harold Shipman would have been stopped before he killed up to 200 people.

Non Capital Health Expenditure

Source: CSO http://www.cso.ie/statistics/non_cap_health_expend.htm

GMS Payments to Pharmacists, Doctors & Dentists

Source: CSO http://www.cso.ie/statistics/non_cap_health_expend.htm

Primary Care Reimbursement Service

Cost of MRPs(Medication Related Problems)

Tangible

• My example cost €230 What if that was Anti-TNF therapy?

What If that was every 3 months to medical card patients?

• 25,000 patients = €23m• 100,000 patients = €92m• 200,000 patients = €184m

• It was actually every month

Intangible

• A & E trolleys occupied• Hospital beds occupied• Additional cost of treatment• Deaths• Legal claims• Psychiatrists

• Prescription drug errors injure over 1.5 million patients each year in the U.S.(Source: MSNBC.com)

• In 1994 one University Hospital in the U.S. had 1911 MRPs at a cost of $1.5m. Source: American Journal of Health-System Pharmacy.

• Tallaght Hospital reported 290 incidents between Oct and Dec 2004.Source: OECD Report by Tim Delaney FPSI AMNCH Tallaght

The Detractors will say• We are working on that. No they are not!

• Pharmacists won’t like it. In times of austerity pharmacists need to be seen to be acting in the public

interest.

• We need a unique patient code. You already have one.

• Pharmaceutical companies won’t approve But remember that as you get better patient compliance the usage of drugs will

increase and that is in the industries interest since sales will increase.

• Doctors won’t like patient access.• That is already being done in the United States.

• What about existing systems?• What about Patient Data Security?• It will be too expensive.• However the real reason is?

Resistance to change

Against1. Cost2. Pharmacists.3. Resistance to change.4. Resistance to new IT solutions.

For1. Reduce A & E. chaos. 2. Reduce pressure on hospital beds.3. Limit Legal claims.4. Save Lives.5. €184 million every year.

Why should you force change?

What will it cost?• E Tender €8m - €10m and 3 - 4 Years

• In House €1m - €1.5m 12 - 18 months

• Who owns the IP Export potential

Win - Win