1. Administration in Community Pharmacy (ADM Profile)
Outlook on profile creation
Jürgen Brandstätter, MSc
Co-chair, IHE Europe
Co-chair, Pharmacy Planning committee
Co-chair, Global Deployment Coordination Committee (GDC)
Member, IHE International Board
CodeWerk Software GmbH, Austria

2. Administration vs Dispense
A Dispense is an act where medication is handed over to the patient
… or someone getting it for the patient
usually done at a Community Pharmacy
It can be recorded by Healthcare professionals (high „trust“)
Downside: Is is not clear, whether the patient will take the medication or not
Nearer to the truth than Prescription, farther than Administration
It‘s always a „one-time“ act (not a time-span act)
Special case: partial dispenses, which are several „one-time“ acts
Administration
An Administration is an act where medication is administered into the patient‘s body
In Community Setting most medication is taken by the patient himself, without a Healthcare professional present
More and more tools available for recording this („apps“)
Trustful enough to add this information to the medication list??
But there are some cases, where also Administration can be recorded by Healthcare professionals:
Controlled drug administration in front of the pharmacist
Contrast medication at the Radiology departement
Vaccinations
Ambulant Chemo therapy
Administration of medication by devices (insulin pump, …)
etc. - they become more in the future!
Administration can be a „one-time“ act (taking a pill, injection, etc.) OR an time-span act (infusion)
More than a Technical Standard: IHE as framework for HIE

3. Example for a simple ADM
PRE item
Injection
2 times a day
for 1 week
5 injections in a package
3 packages to dispense
DIS item
1 package
with 5 injections
ADM item (1 inj)
ADM item (1 inj)
ADM item (1 inj)
DIS item
1 package
with 5 injections
ADM item (1 inj)
ADM item (1 inj)
ADM item (1 inj)
DIS item
1 package
with 5 injections
ADM item (1 inj) :
ADMs can be related to PRE and/or DIS
ADMs may also be recorded standalone

4. More than a Technical Standard: IHE as framework for HIE
ADM recording
One-Time Administration
Date/Time: Point of date/time
Recorded what happened at this point of time
2 pills taken, 1 application of the cream, etc.
Time-span Administration
Date/Time: Start date/time – End date/time
Recorded at the end of the time-span
Complex scenarios like „drop-rates of the infusion changed during the time“ can be recorded either
(1) „summarized“ (average drop rate) or
(2) „detailed“ (every change of the drop rate is recorded as separate ADM)
ADM records may reference another ADM as predecessor to document this
More than a Technical Standard: IHE as framework for HIE

5. ADMs in a medication list
Goal: Make medication list of a patient as „accurate“ as possible
1) We know every medication which is currently active within the patient‘s body
Best covered by ADM, because it‘s assured the medication entered the patient‘s body
If ADM not available: DIS
2) We know every medication which the patient is going to take in the future
DIS: This medication the patient already has in his hands and will most likely take
MTP: This medication is planned
Medication list hierarchy
DIS beats its PRE
ADM beats its DIS
More than a Technical Standard: IHE as framework for HIE

6. Integrate ADM into CMPD
Other CPs required also for MTP, PML
Medication Administration performer
More than a Technical Standard: IHE as framework for HIE

7. Jürgen Brandstätter, MSc