CHANGES YOU AND YOUR STAFF NEED TO KNOW ABOUT

Transcription

1 Taranaki DHB Electronic Discharge Summary & MedRec Upgrade CHANGES YOU AND YOUR STAFF NEED TO KNOW ABOUT Community Pharmacy & GP s November 2015

2 Overview Taranaki DHB is required to upgrade it s operating systems to be able to operate on IE11. The impact of this is that Taranaki DHB is required to Upgrade the Electronic Discharge Summary & MedRec application to a new version that can ONLY use the new NZULM Medication Dictionary (NZ Universal List of Medicines) This is an important step on the path to achieve INTEGRATION of medication management applications, as well as between Community and Hospital

3 Overview NZULM Upgrade new features

4 NZULM How it will affect you? What does this mean for Community Pharmacies, GP s and Rest- Homes? The Hospital will be on a different Medication Dictionary = NZULM (until GP applications transition from MIMs to NZULM) Hence NAMING CONVENTIONS FOR SOME MEDICATIONS WILL BE SIGNIFICANTLY DIFFERENT & others maybe be slightly different for Discharge Scripts, Discharge Summaries, & online viewable Discharge and emedrec documents Inform your patients About changes in medication naming & ask them to Check unexplained new medications carefully with their Pharmacist or GP

5 NZULM How it will affect you? What does this mean for your patients? Patients may get a script for a medication from the DHB, that has a different name compared to the: Label on their medication box or Repeat script that the GP gives them eg dosulepin NZULM vs dothiepin MIMS and hence Patients may think that they are TWO different medications when in fact they are the same (note : leaflets about NZULM name changes will be provided to patients on discharge)

6 NZULM How it will affect you? Medicine name changes Forms Salts eg sodium valporate = valproate sodium ie names transposed Single ingredient eg dothiepin = dosulepin frusemide = furosemide Two ingredient eg frusemide + amiloride = amiloride + furosemide ie names transposed Multi-ingredient eg Gaviscon - magnesium alginate + sodium alginate = alginate magnesium + alginate sodium (see slides at end of presentation for a list of common examples)

7 NZULM How it will affect you? NZULM New drug dictionary If unsure CHECK naming conventions on the NZULM website OR check the MIMS Gateway as per next screen shot

8 NZULM NZULM How it will affect you? Or alternatively CHECK naming conventions on MIMS Gateway

9 Upgrade - New features BRANDS as listed on electronic Discharge Scripts & Discharge Summaries Brand Restricted Nationally approved list (8) - see attached list Always prescribed as brand & the brand will be listed first The online viewable Discharge Summary they will have a next to the listing see example of the Discharge Summary on separate slide Brand Designated by prescriber & is included in the 2 nd line on the script. If a Brand is included, then no substitution is permitted (Note: please check with the patient first if this is not the normal brand dispensed)

10 New features DURATION may now be listed on electronic Discharge Scripts & Discharge Summaries Ongoing Duration Deliberate selection by prescriber Displayed on scripts & Electronic Discharge Summary Fixed Duration Deliberate selection by prescriber Displayed on scripts & Electronic Discharge Summary Please check Start Date & Duration carefully, in addition to the Quantity to be supplied

11 Script Display Scripts will now include MedRec information (if the patient is initiated) at the end as displayed below:

12 emedrec - Discharge Summary on line display

13 Future Features Electronically Printed Patient Medication Cards (=Yellow Card) Additional Warfarin information included in Discharge Summaries Discharge dose, Indication, dose history while inpatient Blister Pack and Regular Community Pharmacy details displaying on the Electronic Discharge Summary We will advise when these features are available watch out for our updates

14 YOUR FEEDBACK IS IMPORTANT TO US There are some configuration functions we can change at a local level and some we can request from the Vendor Please jo.appleyard@tdhb.org.nz for concerns, suggested improvements, or issues you maybe experiencing with functions from this upgrade

15 NZULM examples Please see a small set of examples in following slides a more comprehensive printable list will be provided separately If there is a medication that you are unsure of or there is an unexplained complete change of medication for the patient Check the NZULM / MIMs Gateway websites for naming convention Check TDHB online documents Contact the prescriber at Taranaki DHB Discharge Summary and emedrec

16 Forms Medication (if applicable) Form NZULM Form All turbuhaler powder for All aerosol pressurised

17 Mandated Brand Restricted Drug or Drug Class eg. Brands Name BRAND NAME Mandatory MSEAG Diltiazem MR Apo-Diltiazem CD, Cardizem Not interchangeable CD Warfarin Marevan, Coumadin Not interchangeable Beclomethasone diproprionate MDI Beclazone, Qvar Different potency of Qvar Insulins All Patient familiarity Ciclosporin Neoral, Dexiclo, Neoral Not interchangeable Tacrolimus Tacrolimus Sandoz Not interchangeable Morphine Oral MR Arro-Morphine LA, LA Morph, m-eslon SR Different release characteristics

18 Salts Medications with Salts sodium citrate sodium valproate NZULM Salt transposed citrate sodium valproate sodium

19 Single Ingredient Medication alendronate amoxycillin Bonjela bendrofluazide calcium folinate cephalexin cholecalciferol Creon dothiepin eformoterol erythropoietin ferric carboxymaltose flupenthixol frusemide NZULM Medication Name alendronic acid amoxicillin salicylate choline bendroflumethiazide folinic acid cefalexin colecalciferol pancreatin dosulepin hydrochloride formoterol epoetin iron (as ferric carboxymaltose) flupentixol decanoate furosemide

20 Single Ingredient Medication fusidic acid heparinised saline hydroxyurea Liquifilm or Vistil Forte oestradiol oestradiol valerate oestriol oestrogen oxpentifylline Vitamin K (Konakion) salcatonin senokot trimeprazine Vitamin E oral liquid NZULM Medication Name fusidate sodium heparin sodium hydroxycarbamide polyvinyl alcohol estradiol estradiol valerate estriol estrogen pentoxifylline phytomenadione calcitonin (salmon) sennoside alimemazine alpha tocoferil acetate

21 Two Ingredient Medications with 2 Ingredients amiloride + hydrochlorothiazide frusemide + amiloride benserazide + levodopa carbidopa + levodopa NZULM Names transposed hydrochlorothiazide + amiloride amiloride + furosemide levodopa + benserazide levodopa + carbidopa

22 Multi-Ingredient Medication Multi-ingredient cotrimoxazole Gaviscon infant liquid calcium effervescent Calsource Emla Emulsifying ointment (Health E ) ferrous sulphate + vitamin C Sofradex eye drops Macrogol sachets (Lax ) NZULM description trimethoprim + sulfamethoxazole alginate magnesium + alginate sodium calcium carbonate + calcium lactate gluconate lidocaine + prilocaine hydrochloride paraffin liquid + paraffin soft white + waxemulsifying ferrous sulfate + ascorbate sodium dexamethasone + framycetin sulfate + gramicidin sodium chloride + sodium bicarbonate + potassium chloride + macrogol-3350

23 Medication Multi-ingredient NZULM description Maxitrol dexamethasone + neomycin sulfate polymyxin B 6000 Multivitamin (M-Vite ) ascorbic acid + colecalciferol + nicotinamide + riboflavin + thiamine hydrochloride + retinol Mylanta P aluminium hydroxide + magnesium hydroxide + simeticone Proctesedyl cinchocaine + hydrocortisone Potassium Chloride potassium chloride + potassium bicarbonate + (Chlorvescent ) potassium carbonate sodium citro tartrate, sodium bicarbonate + Sodium citro-tartrate (URAL citrate sodium anhydrous + citric acid + ) sachets tartaric acid Ultraproct cinchocaine + fluocortolone hexanoate + Ointment fluocortolone pivalate Vitamin B Complex (B-plex ) Multi-Ingredient nicotinamide + pyridoxine hydrochloride + riboflavin + thiamine nitrate