Electronic Medication Management Systems – Overview

An EMM system is a system of prescribing, supplying and administration of medications. All the medication activities doctor prescriptions, review and dispense by a pharmacist, and administration by nurse are managed through this system.  EMM system increases patient safety by improving prescription legibility, right amount of dose calculation, and clinical decision support thus reduces medication errors.  EMM system ensure safe onscreen display of information related to particular medication, error alerts and dose calculators with prompts to check certain pathology or clinical information with certain drugs.  EMM system refers National Tall Man Lettering list when prescribing similar sounded medicines to distinguish from one another. For example niFEDIPine and niMODIPine are two similarly sounding drugs.

A well implemented EMM system with standards would implement the following main categorical functional components for better medication management and clinical support decisions.

General

a) Access to latest pathology results : When making decisions on medication orders, it is important to access latest pathology results to interpret the reason or indication.

b) Access to latest patient clinical information : It is important to access latest patient clinical information such as blood pressure, pulse, weight etc. to assist in medication orders and clinical support decisions.

c) Access to previous and current medication records : Access to previous and current medication records such as previously ordered, administered, ceased or withheld is required to fully inform clinicians.

d) Recording of medication history on admission  : Medication history such as prescriptions, over the counter and complementary medicines along with dosage quantity, frequency is recorded.

Medication orders

a) Selection of medicines and directions : System ability to allow prescribers to select medicine names, form, frequency, route, strength, dosage and duration of therapy.

b) Allergy and adverse drug reaction(ADRI) information : System ability to present patient allergy information and ADR status when patient initially registered.

c) Public hospital formulary : System ability to restrict ordering of certain medicines to certain prescribers according to local public hospital formulary. For example cytotoxic medicines limited to oncology specialities, restricted antibiotics to infectious diseases specialists.

Clinical decision support

a) Active alerts : System ability to present active alerts such as prompts, reminders, error alerts etc. at the time of decision making.

Medication dispensing

a) Recording of medicines dispensed : System ability to record medicines dispensed. This helps clinicians to review new medication orders.

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