Improving medication safety by cloud technology: Progression and value-added applications in Taiwan

https://doi.org/10.1016/j.ijmedinf.2019.03.012Get rights and content
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Highlights

  • We developed an integrated cloud technology to improve medication safety in aged societies.

  • The average number of drug items prescribed and medical expenditure decreased.

  • Medication reconciliation was successfully performed by a pharmacist.

  • Further reductions in medical expenditure and improved patient safety are expected.

Abstract

Objectives

To develop and implement an integrated cloud technology with the aim of ensuring medication reconciliation during transitions of care and improve medication safety in aged societies.

Methods

PharmaCloud is a new technical platform adopted by the National Health Insurance Administration of Taiwan to collect patients’ medication information via cloud technology. Using this platform, healthcare providers can access patients’ medication-related information with patient consent. Our hospital applied this technology and developed several approaches to collect and detect medication-related information and alert physicians for the purpose of enhancing patients’ medication safety. In addition, pharmacists were involved in the admission process to access medication data and provide optimal suggestions to physicians. Several indicators, including a reduction in the number of drug items in each prescription and medication expenditure, were employed to evaluate the overall effects of the cloud inquiry.

Results

After the application of PharmaCloud, the average number of prescribed drug items significantly decreased (change of 0.04 to −0.35 per prescription, p < 0.05), and the median medication expenditure significantly decreased by an average of 3.55 USD, (p < 0.05) per prescription. Intra-hospital medication duplication rates also showed a downward trend.

Conclusions

The use of the cloud technology and value-added applications significantly improved patient medication safety. Further long-term beneficial effects in terms of medication safety and medical cost savings are expected.

Abbreviations

HIMICIS
Health Insurance Medical Information Cloud Inquiry System
CPOE
computerized physician order entry
CIS
Charlson Index Score
NHIA
National Health Insurance Administration
NHI
National Health Insurance
CPI
Consumer Price Index
HIS
health information system

Keywords

PharmaCloud
Cloud technology
Health Insurance Medical Information Cloud Inquiry System
Pharmacist
Patient safety

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1

These authors contributed equally to this paper.