Medication Order Reconciliation via Automated ID Assignment
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Solution Overview
Problem
Current hospital information systems face challenges in accurately tracking and reconciling medication administration events, particularly when changes occur during infusion or when oral orders are given without a pharmacy-generated order, leading to incomplete and error-prone medication records.
Innovation Solution
A system that automatically assigns new order identification numbers for medication delivery changes, reconciles these with existing orders, and updates electronic medication administration records, using a server and medication administration devices to compare and communicate medication administration status information.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Adaptability or versatility
If manual entry and reconciliation is used to track medication delivery changes, then flexibility in handling various delivery scenarios is maintained, but accuracy and completeness of medication records deteriorate due to human error
Solution Approach 1:
The system enables automatic self-service tracking where the medication delivery system itself generates and transmits order identification numbers and delivery status information without requiring manual data entry. The system automatically reconciles this information with pharmacy orders, eliminating human error while maintaining adaptability through automated rule-based processing of various delivery scenarios.
Solution Approach 2:
The patent replaces the manual mechanical process of data entry and reconciliation with an automated electronic system. The mechanical action of manually entering and reconciling data is substituted with automated electronic communication between delivery devices and the central system, which automatically matches delivery information with pharmacy orders using algorithms.
2Reliability
If automated tracking systems are implemented to improve accuracy of medication records, then completeness of electronic medication administration records improves, but system complexity increases due to integration requirements
Solution Approach 1:
The system employs a universal server platform that can handle multiple functions: generating order identification numbers, receiving delivery status information from various delivery devices, reconciling with pharmacy orders, and updating electronic medication administration records. This multi-functional approach consolidates what would otherwise require multiple separate systems, reducing overall integration complexity.
Solution Approach 2:
The patent introduces a central server as an intermediary that mediates between pharmacy systems, medication delivery devices, and electronic record systems. This intermediary handles the complex reconciliation logic and data matching, isolating the complexity from the other systems and simplifying their interfaces.
3Loss of information
If pharmacy-generated order numbers are used to track medication delivery, then traceability from pharmacy to patient is improved, but inability to handle oral orders or floor stock usage reduces system versatility
Solution Approach 1:
The system performs preliminary action by automatically generating order identification numbers at the point of medication delivery, even before pharmacy processing is complete. This allows the system to track and reconcile oral orders and floor stock usage prospectively, ensuring traceability is established at the moment of delivery rather than requiring prior pharmacy involvement.
Solution Approach 2:
The system dynamically adapts its tracking approach based on the type of medication delivery. For pharmacy-ordered medications, it uses the pharmacy-generated order numbers. For oral orders or floor stock usage, it automatically generates new order identification numbers and reconciles them accordingly. This dynamic behavior maintains versatility while ensuring traceability for all delivery types.
Data Source
AI summary
A system and method for managing medication orders, including changes to those orders, is described. A server receives medication orders from a pharmacy and communicates those orders to an infusion pump. The infusion pump communicates status messages to the server and the server compares the status messages to the medication orders to determine if the there were any changes to the order, or if a medication was administered absent a medication order. The server assigns a new order identification number to the status message if needed. The system may also reconcile original medication orders with information associated with a new order identification number and stores the information in the eMAR of a patient.