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The Multidisciplinary Approach

F.Y. Teng | March 25, 2013
IHIS, NHG Pharmacy and Southeast Asia's first complete multi-dose medication management system for the Intermediate and Long-term Care Sector.

Mark Winn, IHIS
Photo: Mark Winn

Mark Winn, Director, Clinical Systems, at Integrated Health Information Systems (IHIS)—the Health Ministry's IT arm—gave a presentation at the Singapore edition of this year's CIO Awards & Conference. Winn shared essential details of his organisation's most successful project with all those in attendance at the Marina Mandarin on March 13, 2013.

IHIS provides for the IS needs of about 30,000 users who work across the public hospitals, specialist centres and polyclinics of Singapore. And the 2013 CIO Award-winning Multi-dose Medication Management (MMM) system, which it set up in partnership with NHG Pharmacy, now sees to the highly efficient prepacking of medicines, and their dispensation to patients suffering from chronic illnesses, particularly those with poly-pharmaceutical needs.

The aging group makes up about 20 percent of the Singapore population, Winn told the audience, adding that 1 in 4 of the members of this group is suffering from a chronic disease. He moved on to talk about how this group used more medications than any other age group, stressing the prevalence of polypharmacy among them, and about the risk of medication errors this group were open to.

Referencing a 2004 study (Polypharmacy and Inappropriate Medication use in Singapore Nursing Homes by K Mamun, Lien, Goh-Tan, Ang, Ann Acad Med Singapore), Winn said that 60 percent of the elderly in the country came under the polypharmacy category of medication users, 70 percent of them have used medication inappropriately, and that there was clearly an "increased potential for adverse drug evnents" among them. And citing from the Institute of Medicine (IOM) Report 2006, he said that medication errors annually harm 1.5 million people in the US and that US$3.5 billion is "spent on treating the consequences of medication errors" every year.

After establishing the raison d'etre for the MMM system, Winn set about outlining the major issues it is meant to resolve-such as those to do with medication storage, resource constraints and medication management-and stressed the importance of adopting a multidisciplinary approach to putting it together.

Together, Winn's team at IHIS and their partners at NHG Pharmacy soon became the first people in Southeast Asia to build and rollout "a complete multi-dose medication management system for the Intermediate and Long-term Care Sector, or ILTC." One that enhanced patient safety by offering an "integrated process where pharmacists reconcile and review all medication prescriptions in nursing homes" and that helped them deliver customer-centric service through the "innovative use of packing machine[s] to combine patients' own medications with other institution-supplied medications into ready-to-administer sachets."


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