1. Electronic Medication Management (eMM) Dr Stephen Chu Chief Clinical Informatician & Terminologist Clinical Terminology & Information, NEHTA Landscape and Concepts – eMedication Management Stack – concepts and scope

2. Electronic Medication Management Three key components Contents Infrastructures o Trigger events; messages; services o Registry; repository Applications/User interface/viewer eMM: Landscape

3. Electronic Medication Management Key landscape components eMM: Landscape eMM Repository SEHR/ PHR Registry/ Directory Triggers Messages Services Contents Applications Interfaces Queries

4. Electronic Medication Management The recipes and ingredients analogy eMM: Landscape Prescrip -tions Dispense Records Pharm Advice Pharm Advice Meds Admin Meds Admin Patient Conditions Patient Conditions Allergies; Adv reactions Contra- Indicat -ions Contra- Indicat -ions Labs … & others… Labs … & others… The data (ingredients) hospitals Community pharmacies Community Labs/paths Community Labs/paths Community Imaging services Community Imaging services others … The sources Executive/ Management Decisions Executive/ Management Decisions Clinical Decisions Clinical Decisions The consumptions Medication Management Medication Management Medication Review Record Reconciled Medication History List Queries Reviews Reconciliation The production (cooking) processes The recipes Patient Medication Record Medication related Reporting Medication Profile Medication Management Plan Unreconciled Medication History List

5. Medication Profile Definitions Medication Profile A set of information about characteristics of a patients medication use Medication Management Profile A set of information about a patients characteristics, which are relevant to safe medication management for this patient

6. Electronic Medication Management Key components eMM: Landscape Complexity Data components (processing, … etc) Prescribed Dispensed Administered ??? Administration/conformance Profile: Max cumulated dose Omission frequency + reasons Dose variation frequency + reasons Frequency variation frequency + reasons Intermittent + PRN frequency + reasons Medication Review Record Reconciled Medication History List Queries Reviews Reconciliation The production (cooking) processes The recipes Patient Medication Record Medication related Reporting Medication Profile Medication Management Plan Unreconciled Medication History List

7. Electronic Medication Management Key components eMM: Landscape Complexity Data components (processing, … etc) Long term meds list Short term/episodic meds list Intermittent meds list PRN meds list Types of med list view Medication Review Record Reconciled Medication History List Queries Reviews Reconciliation The production (cooking) processes The recipes Patient Medication Record Medication related Reporting Medication Profile Medication Management Plan Unreconciled Medication History List

8. Top down and bottom up approaches Medication data requirement analysis Prescrip -tions Dispense Records Pharm Advice Pharm Advice Meds Admin Meds Admin Patient Conditions Patient Conditions Allergies; Adv reactions Contra- Indicat -ions Contra- Indicat -ions Labs … & others… Labs … & others… The data (ingredients) hospitals Community pharmacies Community Labs/paths Community Labs/paths Community Imaging services Community Imaging services others … The sources Bottom Up Top down analysis Complementary Cross-referencing Validating Adequacy, accuracy reusability and consistency checks Executive/ Management Decisions Executive/ Management Decisions Clinical Decisions Clinical Decisions The consumptions Medication Management Medication Management Medication Review Record Reconciled Medication History List Queries Reviews Reconciliation The production (cooking) processes The recipes Patient Medication Record Medication related Reporting Medication Profile Medication Management Plan Unreconciled Medication History List

9. Electronic Medication Management Three key components Contents Infrastructures o Trigger events; messages; services o Registry; repository Applications/User interface/viewer eMM: Landscape

10. Medication data – how they are used: through application/Interface design