Perry Flowers is Vice President of Medical Affairs, Enterprise Medication Management at BD.  With more than 27 years in pharmacy and leadership experience, he joined the company in 2018 to advance BD’s mission to transform medication management in meaningful ways.

What is the medication management process and how should CIOs approach it?

The medication management process is the full end-to-end life of a medication, starting with procurement and concluding with the administration to a patient in a care space. The intermediate steps along this process are medication storage and preparation occurring within pharmacy areas and then medication distribution to patient care spaces. Historically, these process segments have been addressed by various technologies requiring any number of interfaces that increase an organization’s IT footprint in additional support and maintenance. I believe that CIOs should establish a set of requirements regarding the management process that focuses on meeting patient care quality and safety concerns. For example, by reducing the various number of interfaces and ensuring the integrity of a complete clinical database, the organization might be able to reduce costs and its IT footprint in addition to more effectively meet cybersecurity standards.

When it comes to medical management, how should we evaluate a connected solution model compared to a single-platform model?

While the headlines have tended toward a single platform model in the last several years, many high-risk health processes, like medical management, continue to demand an increased level of examination in both regulatory scrutiny and accreditation risks. This is where a connected model can address what a single platform struggles to do: absorb all the process segments within a high-risk process and integrate these steps into a single stream to ensure better patient care. For example, a single-platform model like the EMR cannot meet the necessary documentation in the preparation of medications and of controlled substances handling. We have found that to meet the increased scrutiny and risk around medication, management can only be achieved through a connected process model.

My organization has made a considerable investment with an EMR vendor. Can other vendors co-exist with an integrated, end-to-end approach?

Yes. I believe organizations and their EMR vendors should recognize the utility of co-existing with an integrated approach. Together, these two models can strategically lessen the technology infrastructure burden of an organization by reducing, removing or consolidating servers and interfaces. To support this, a strict evaluation of the medication management process would produce a deliberate design to connect all parts of the medication management process from procurement to point-of-care administration. To meet the requirements for highest quality control, organizations should establish a co-existence framework where their EMR platform remains the foundational base upon which a connected management model can run quality controls, and enhance their clinical databases and operational analytics. Organizations might also consider that the specialized capabilities of an integrated model can help them meet the increased demand for regulatory and accreditation bodies, enhancing the considerable investment they made with their existing infrastructure.

What are a few examples of the quality and patient safety issues related to the medication management process?

The medication management process continues to be held to higher standards amidst a handful of serious and tragic medication-related misadventures dating back to the Institute of Medicine (IOM) report “Preventing Medication Errors” published in 2007 as part of their Quality Chasm series. This report identified medications as an important contributor to patient harm. Some of the most startling examples of safety issues cited were when concentrated medications were incorrectly administered to newborn babies and when adult medications were administered through an incorrect route. More than a decade later, we’re still struggling with many of these same issues and we continue to see examples too close to the reality of that 2007 report. The transition to the EMR platforms was an important first phase in improving patient care and safety, but now we need connected solutions like medical management for those processes segments that pose high-risk safety concerns.

Why BD?

When we consider the hundreds of thousands of medications making their way through a single hospital or health system each day, it’s no wonder that medication errors and inefficiencies, as mentioned above, arise. At BD, we are committed to simplifying the management process to break the cycle of medication error and offer safe, quality patient care. Our integrated platforms and point-of-care technologies aim to reduce inefficiencies in the medication-use process (from pharmacy to the patient’s bedside) and improve safety across the continuum of care.