Hospital pharmacy St Jansdal

How can we optimize our medication monitoring?

Gaston Pharma^®

Hospital pharmacy St Jansdal received numerous irrelevant medication monitoring signals due to electronic prescribing based on the G-standard. Due to the resulting reporting fatigue, they wondered: how can we reduce the number of reports to the reports that really require action.

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How can we optimize our medication monitoring?

Our role:
Gaston Pharma was asked to help significantly reduce the number of irrelevant reports.

This is how we worked together

Gaston and St Jansdal worked closely together with one goal: optimal medication safety for patients.
A baseline measurement was used to map the most common interaction reports.
For each interaction report, it was examined which patient characteristics were needed to prevent the report or make it more relevant. Consider age, gender, lab values, administration times and co-medication.
Using expert panels the workflow and relevant settings were defined for hospital, physician and pharmacist. These settings served as input for the clinical rules to be built.

Our collaboration is more like a partnership. We have the same goal: optimal medication safety for patients

Pieter Helmons

Hospital pharmacist, PhD, MAS

Technical integration

Gaston Pharma linked all hospital and pharmacy systems involved in electronic prescribing.
Using the Gaston Pharma editor, the clinical rules were entered and linked to the Pharmacy Information Systems (AIS) and Hospital Information Systems (HIS).
Gaston Pharma combined the required patient characteristics, lab values, administration times and co-medication to generate more specific Alert texts for the doctor or pharmacist.
Gaston Pharma feeds combined information back to the electronic prescription system or Pharmacy Information System.

The results

There was an average 86% reduction in the number of alerts and the number of reports is now largely limited to relevant reports that require immediate action from a doctor or pharmacist.

The project has resulted in numerous scientific publications and a dissertation and has also been positively discussed in various media. The entire system was delivered in 2016.

Helmons PJ, Suijkerbuijk BO, Nannan Panday PV, Kosterink JG. Drug-drug interaction checking assisted by clinical decision support: a return on investment analysis. J Am Med Inform Assoc. 2015 Jul;22(4):764-72
Helmons PJ, Suijkerbuijk BO, Nannan Panday PV, et al Doing the right things and doing things right: inpatient drug surveillance assisted by clinical decision support Eur J Hosp Pharm Published Online First: 22 May 2015. doi: 10.1136/ejhpharm-2014-000505