AutumnCare to let GPs connect for medications profile

Aged care software vendor AutumnCare is building functionality to enable general practitioners to view a full medications profile of their patients in residential aged care facilities, generated by AutumnCare's Medicate module.

GPs are currently able to remotely log in to the system to request medication changes from the resident's nominated pharmacist. The changes are automatically inserted into Medicate and an alert emailed to the pharmacy.

Medicate, which was launched last year, allows aged care facilities to easily create a medications profile containing full demographics, the resident's regular packed medications, non-packed medications, as-needed medications (PRNs) and stat medications.

Medicate is fully integrated with pharmacy packing systems Webstercare and Fred Pak, which AutumnCare managing director Stuart Hope said covered about 80 or 90 per cent of the pharmacy market. The company is currently working on integration with smaller players MTS and PractiCare.

AutumnCare is able to normalise the data from Webstercare and Fred Pak and integrate that data back into Medicate.

Mr Hope said while the company would do a pilot of the GP log-in function before releasing it widely, version 4.5 of AutumnCare is due early next year and will have a number of functions that he has been keen to add to the product for some time , including a dynamic Glasgow coma scale and the ability to chart all vital signs in a dynamic way. “It's very sexy,” he said.

AutumnCare is also building functionality within Medicate to allow nurses to see when a medications patch has been applied and reapplied. Medications are increasingly being delivered by dermal patches, which can prove difficult to track within traditional systems as they often applied on different parts of the body, can come loose and need to be reapplied, and some are meant to last 24 hours but others for several days.

“We building some snapshots so you'll be able to see a patch that was applied, checked, went missing and had to be reapplied, so it resets the clock essentially for that particular patch,” Mr Hope said. “The patches were problematic ... there were 17 pages of C# code.”

The company is also working on full MIMS integration, and while it won't have full electronic prescribing under national standards until legislation is changed to allow it, the system has been designed with that capability ready to go.

Mr Hope told an industry function yesterday that AutumnCare had had medications management as part of its development roadmap since 2005, but as it was a complex area, he had decided to look into companies that specialise in it.

“We had deliberated operating with all of those but none of the products were right, so we decided to go and build our own,” he said.

Medicate is designed for mobility and is perfect for tablet computers, as it has touchscreen functionality. Ann Bourke, director of care and administration at Carramar Home in Stanthorpe in Queensland, said her nurses were using five Motion CL910 tablets on trolleys to do medications rounds across the organisation's two sites.

Ms Bourke said the touch function can be a bit of problem as the boxes that need to be ticked are quite small, so Carramar purchased some styluses, which also allow nurses to do hand-written notes in the system. They can also use flexible roll-up keyboards and a mouse if they wish.

“They can hand-write comments and some people use it that way but most use the tablet as it's meant to be used,” she said. “The use of tablet computers has far greater flexibility as assessments are all done at the bedside and you are entering the data straight away.

“How many PCAs do you see walking around with little notebooks and they are writing everything down, and the RNs and ENs are doing the same thing, then they have to come back and type it into the computer? That is fraught with danger.”

She said Carramar had also purchased two new tablets to use for wound care. In AutumnCare's current version, nurses are able to take a photo of a wound with the tablet and it is automatically downloaded into the resident's file on the system.

“Those tablets sit on the wound care trolley, and we do all of our wound management straight onto the tablet,” she said. “We take a photo of the wound and download it and it's all there.”

Mr Hope said that while Medicate had been built from an aged care facility perspective, it had also taken into account pharmacy requirements.

“We treat the pharmacy as the source of truth so what is dispensed and packed is what we get,” he said. “One of our key philosophies when we were building the system is that the pharmacist didn't have to do any more work.

“We take data from AutumnCare and from the pharmacy so if you administer a PRN it automatically creates a progress note and marks it at handover. It is also integrated on the web so GPs can go to a secure website or if they have a smart phone they can log on and put in medication change requests.”

Ms Bourke said her residents' GPs were happy to put in medication changes once they got used to the system. “They want to be able to see the changes they were making and see that that change had happened,” she said. “And by logging in and doing that, that is their signature for the medication.

“No disrespect to GPs as they are very busy people, but sometimes they put in a medication and then another, and they forget to take [old prescriptions] off.”

She said by using the AutumnCare system, pharmacists have been able to call the GP to check that older medications were still required. “That has been great,” she said. “That has improved outcomes for residents.”

Mr Hope said that while he was working on the ability to allow GPs to remotely access the full medications profile, he doesn't yet have a firm timetable for it.

What he does have is firm criticism of the standard designed for the National Prescription and Dispense Repository (NPDR), which is aimed at allowing healthcare practitioners to see an up-to-date medications list.

Mr Hope said he does not consider it suitable for aged care. “The NPDR does not have rigorous data definitions that are suitable for the administration of medications in aged care.

“The model for the NPDR had been based upon the premise that someone can walk into a pharmacy,” which isn't the case for residents of nursing homes, he said.

“The NPDR is basically free text – it is not a rigorous specification for medication. We do integrate with it and we have passed all our testing, we've got our notice of compliance and certificates, but it's not effective. It should be a national dispensing standard so that you can dispense from anywhere and then it feeds the appropriate systems.”

Posted in Aged Care

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