1. IHE Pharmacy Hosiptal admission & discharge Michael Tan Product manager 19 march 2013

2. Topics Workflow of hospital admission & discharge Focus on transfer point between external and internal processes Internal hospital flow not in scope 2IHE Pharmacy

3. Actors Hospital Pharmacists, physicians Community pharmacies General practicionars Other institutions such as nursing homes, mental hospitals Other hospital pharmacies Drug information systems IHE Pharmacy3

4. Workflow Admission Patient being admitted in hospital for treatment ( operation). Intake consult. Interview with pharmacist or physician. Review process of medication profile: Collect information from other systems ( pharmacies, GP, DIS, Repository). Patient has an existing medication profile on paper Patient has taken a bag of pills along Care provider reviews and reconciles the various inputs, resulting in a current medication status. This is registered into the EHR of the hospital. Care provider makes decisions for new medication therapy: Medication is continued: same brand under new prescriber. Same dosage. Medication is altered: new prescription with other brand or dosage. Medication is stopped: In Netherlands hospitals medication is included in the costs and new prescriptions are mandatory. The other actors (prescribers, pharmacists) are informed of the altered/ terminated prescriptions. IHE Pharmacy4

5. Flow IHE Pharmacy5

6. Workflow discharge Patient has an exit consult with prescriber. Care provider reviews the last medication profile from the hospital EHR. Prescriber sets up a new medication therapy: Collect the information from the EHR and the status before admission ( including the stopped therapies). The hospital prescriptions are stopped. New prescriptions are made for the ambulatory setting. The prescriptions are sent to community pharmacy. Some discontinued medication from the period before admission are reinstated. Others are permanently stopped ( not reinstated). The other care providers are informed: either with a medication profile (digital/print out) or copies of the prescriptions are sent to other care providers. IHE Pharmacy6

7. Exit flow IHE Pharmacy7

8. Vragen 8IHE Pharmacy Michael Tan Product manager www.nictiz.nl