Information systems in pharmacy
practice
What about is the lecture?
three main topics, which will be discussed:
• 1) Pharmacy information management
systems
• 2) Information systems like information
references for your pharmacy practice
• 3) SPC, PIL
Pharmacy Information systems
Complex computer systems - maintenance of the
pharmacy.
Traditional pharmacy systems are focused on handling
with prescription and on the inventory management.
New generation of these are pharmacy information
management systems, where there can be followed
patient medication profiles, new generation is able to
cooperate with other systems and databases - like real
time transmission knowledge of medicinal products from
expert resources, alerts and warnings.
Pharmacy Information systems
• could be incorporated in the whole complex
hospital management system.
• server plus station
• Thanks this is ensured:
– Real-time sharing information for all users of this
system
How to find the right or well designed System for
your pharmacy?
There are mentioned some requirements:
• system availability
• possibility of improving - in accordance to new
legislation requests
• recovery from failure / reliability
• response time
How to find the right or well designed System
for your pharmacy?
This systems have to fulfill this functions:
• Controlling of inventory and supplying management
• Storage, Security –
• Dispensing •
Compounding - financial information for billing and charging,
• Other Administration – Reports
• Monitoring
Where there is the eventual application of such
software in the pharmacy?
• In the PC at the place of dispensing (and in the
office)
• In some countries are used Automated
dispensing cabinet or Packaging systems
• In the laboratory in the device called "Robotic
IV automation devices"
some examples of Pharmacy information
management systems
International. examplex
• Best Rx (Best Computer Systems)
• Compusolve
• FSI Pharmacy Management System
(Foundation Systems)
• HBS Pharmacy Software (Health
Business Systems)
• IPS Workflow (Suite RX)
• Liberty (HCC)
• NRx (QS/1)
• OPUS-ISM
• PC1 (PDX)
• Pharmacy Management System
(Cerner/Etreby)
• Pharmacy-RX (McKesson)
• Pharmaserv (McKesson)
• PioneerRX (NewTech Systems)
• Prime Rx (Micro Merchant Systems)´´
• …
Czech republic
___________________________
____________________
• In the Czech republic:
• Mediox
• Lekis
• PenWin
• Los Maxima
• In the Slovak republic:
• Nautilus Pharmacy
Automated dispensing cabinet
Automated dispensing cabinet
• input of information and proceeding:
Automated dispensing cabinet
• the end of the chain - final automated
dispensing
• Because this tools (automated dispensing
cabinets) are useful tool for Medication
Control, their are all the time discussed topics
of many journals and conferences:
Automated dispensing cabinet - packaging systems
• Another, but similar tool are packaging
systems:
Automated dispensing cabinet - packaging systems
• in the end, the medication package for the
patient is customized, and patient obtain all
needed information on the back or front side
of the package.
Automated dispensing cabinet packaging
systems
Robotic IV automation devices
• This robots automatically prepare hazardous
intravenous (IV) solutions.
• E.g. company Health Robotics is a supplier of
life-critical intra-venous medication
preparation, compounding - called CytoCare
Robot (and dispensing robots, software
automation solutions. ):
Barcode and pharmacy practice
Why is the coding through barcode important for pharmacy practice?
• A barcode is an optical machine-readable representation of data
• Originally barcodes systematically represented data by varying the
widths and spacings of parallel lines, and may be called as linear or
one-dimensional (1D).
• Afterwards they evolved into other different shapes - like
rectangles, dots .. - in two dimensions (2D).
• Optical scanners called barcode readers.
• Nowadays, scanners and interpretive software became available on
devices including smartphones, tablets..
Which codes are used?
• •EAN-8, EAN-13 (European Article Numbering )
• •UPC (Universal Product Code)
Barcode and pharmacy practice
• 2D - FMD
Barcode and pharmacy practice
• Another use of barcodes in the pharmacy is:
• „Batch code“ – printed in the pharmacy, at
this moment is not the "batch" used in the
meaning "products prepared in one
manufacturing cycle".
• At this point of use all the barcode include
information about deliver date, supplier,
expiration, pharmacy retail price and co-
payment.
Barcode and pharmacy practice
QR code
• Initially developed, patented and owned by
Toyota
• Can encode text, music, images, URLs, emails…
• Quick Response Code
• How to read QR codes - e.g. with application
downloaded in mobiles, tablets..
Information for pharmacy practice
Another question for pharmacist, who are taken in the
concept of 7 star pharmacist as Information Manager Where
to search valid and up-to-date information?
We need to search:
• News about medicinal products, treatment, diseases
• Clinical trials
• Product announcements
• Guidelines, regulations
Information overload
• Which leads to information overload.
Information
• When searching for information on a topic, it is important to understand the value
of the sources.
• Primary sources - original ideas, events, and empirical
•
• Secondary sources analyze, review, or summarize information in primary resources
or other secondary resources.
• Tertiary sources provide overviews of topics by synthesizing information gathered
from other resources. Tertiary resources often provide data in a convenient form
or provide information with context by which to interpret it.
Source criticism in medicine
•"evidence based medicine" (EBM).
Information about medicinal product
• The most detailed information about
medicinal products are called Summary of
Product Characteristics - abbreviation (SPC or
SMPC)
SPC
QUALITATIVE AND QUANTITATIVE COMPOSITION
PHARMACEUTICAL FORM
Therapeutic indications
Posology and method of administration
Contraindications
Special warnings and precautions for use
Interaction with other medicinal products and other forms of interaction
Fertility, pregnancy and lactation
Effects on ability to drive and use machines
Undesirable effects
SPC
• PHARMACOLOGICAL PROPERTIES (Pharmacodynamic and
Pharmacokinetic properties, Preclinical safety data)
• PHARMACEUTICAL PARTICULARS (List of
excipients, Incompatibilities, Shelf life, Special precautions for
storage, Nature and contents of container, Special precautions
for disposal of a used medicinal product or waste materials
derived from such medicinal product and other handling of the
product)
PIL
Patient information leaflet: provides information on using the medicine safely.
„User’s information about the product written by the manufacturing pharmaceutical company“
• ( Package leaflet for veterinarian products)
• All lmedicinal product with marketing authorisation have to include in the package such a leaflet
• Official bodies - like in Europe - EMA - creates guidelines that must be followed when the patient
information leaflet is written.
EMA’s guideline:
• Language: simple words, short sentences, medical terms translate into language which patient can
understand
• Style: “active style”
• Type size, font, paper
• Headings - eg "What is it and what it is used for?"
PIL
The content:
•What is it and what it is used for
•What you need to know before you take or use it
•Warnings and precautions
•Children
•Other medicines and the product
•The product with food, drink, and, alcohol
•Pregnancy and breast-feeding and fertility
•Driving and using machines
•How to také or use it children and adolescents
•If you take or use more than you should
•If you forget to také or use it
•If you stop taking or using it
•Possible side effects
•How to store
•Contents of the pack and other information
PIL
Notes:
• Combined package leaflet for different
strengths or different drug forms – allowed by
National authorities
• Package insert - in he U.S.
• requirements for patient package inserts –
FDA
Micromedex
Thomson Reuters Micromedex is the most reliable, trusted name in
evidence-based clinical reference
Best benefits:
•reliable content
•user-friendly enhancements
Unfortunatelly the access is not for free:
Who is it for?
•Clinicians
•Physicians
•Pharmacists…
• •
Micromedex
• What is the content of Micromedex?
• Information related to medicinal products,
treatment, patient education, toxicity
How does it work?
• Provides a wide range of databases
Micromedex
•AltCareDex®
•AltMedDex® System:
•Clinical Checklist™
•ClinicalPoints® System
•DISEASEDEX® System: (General Medicine, Emergency Medicine)
•DRUGDEX® System
•DRUG-REAX® System
•HAZARDTEXT®
•IDENTIDEX® System
•IV INDEX® System - IV Compatibility
•POISINDEX® 2.0
•REPRORISK® System:
and many others..
Micromedex
Diseasedex Emergency Medicine
•Comprehensive source of urgent and acute care information
•Treatment
•Diagnosis
Diseasedex General Medicine
•Evidence-based, current disease information
•Diagnosis
•Treatment
•Complication
•Prognosis
•Follow-up
•Prevention, screening
•Advising the patient
Micromedex
Drugdex system
Detailed drug information:
•Dosage
•Pharmacokinetics
•Interaction
•Adverse side effects
•Contraindication
•Comparative drug efficiency
•Indications, therapeutic uses
•Generic names
Micromedex
Drug-reax system
•Drug interactions
•Drug – drug
•Drug – food
•Drug – disease
•Drug – alternative medicine
•Drug – ethanol
•Drug – tobacco
•Drug – laboratory
•Drug – pregnancy
•Drug – lactation
Hazardtext Hazard Managements
•Chemical safety in the workplace
•Identification, synonyms, clinical effects
•Range of toxicity, minimum/maximum lethal exposure
•Workplace, environmental standards, labels, shipping, handling storage
•Fire hazard, explosion hazard, reactivity hazard, ...
•Protection
Micromedex
Identidex System
•Tablet and Capsule Identification
•Imprint code
•Color
•Dosage form
•Active ingredients
•Manufacturer
Poisindex
•Identify ingredients for commercial, pharmaceutical, biological substances
•Information on range toxicity, treatment protocols for exposures involving
the substance
• Micromedex - Interactions checker:
• Severity of Interaction, information about the
documentation of the interaction
Lexicomp
• similar to Micromedex
• „Lexicomp is an industry-leading provider of drug information
and clinical content for the healthcare industry. We provide the
tools necessary to help improve patient safety, ensure
compliance, and elevate the quality of care patients receive. “
• This system is helping healthcare professionals make safer and
faster decisions with easy to use clinical information, advanced
technology, and superior customer service.
• It works like On-line system, Mobile Apps.
Lexicomp
Clinical modules:
•Drug and herbal interaction analysis (Lexi-Interact™)
•Identification of solid, oral drugs (Lexi-Drug ID™)
•Comprehensive medical calculations (Lexi-CALC™)
•King Guide to Parenteral Admixtures (Lexi-I.V.
Compatibility™)*
•Patient education module: Printable patient leaflets
providing drug, disease, condition and procedure information
for your patients
•Medical Internet search portal (Web Search)
•Assessment, diagnosis, and treatment of poisonings and
drug overdoses (Lexi-Tox™)
…
Web pages
As credible web pages which you can access for free - these
are usually web pages of official National authorities or
International companies or supervisors:
• FDA
• European centre for Disease Control
• Centers for Disease Control and Prevention
• Mayo Clinic (“Mayo Clinic is a nonprofit worldwide leader in
medical care, research and education for people from all
walks of life.”)
• EMA
• SIDC
AISLP
• Note: Czech Information system resembling
Micromedex is called AISLP
• The content:
• Information about human, with marketing
authorisation in the Czech republic
• Information based on documents of state
institutions, manufacturers, web portals
• Update 4 times per year
• Can be linked to other pharmacy management
systems