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Pharmaceutical care trajectory

Care trajectories ensure an optimal transition from an environment to another, for example, when a patient comes back home after his discharge from the hospital. They are based on a shared care plan among healthcare professionals that coordinate their actions to achieve the best possible results for the patient.

Pharmaceutical care trajectories include Medication Reconciliation (MedRec). This process implies to consult the patient’s medication profile and to analyze the entire patient’s file. The MedRec, usually conducted by a pharmacist, allows to communicate specific and comprehensive information to all healthcare professionals concerned by the pharmacotherapy. Furthermore, the MedRec also includes a complete and detailed analysis of the patients’ drug profiles to ensure healthy medication management.

Benoit Cossette, pharmacist, researcher, and teacher, was working on implementing a collaborative project about Magog’s elderly people who are taking several different medications. The challenge? Bridge the gap among all healthcare professionals to ensure a close collaboration. In fact, traditional paper files, as we know them, complicate the collaboration between the hospital pharmacists, the community pharmacists, the general physicians, and the geriatric medicine specialist. A shareable electronic medical record (EMR) was the turnkey solution to allow tight communication between those stakeholders. Joining the forces of the researchers and the clinicians involved with Omnimed was natural to realize this research project.



Research hypothesis:
by simplifying clinical data access between hospital and community clinicians, a shareable EMR will optimize the use of drugs during the transition across care settings.

Objectives

  • Evaluate the feasibility of implementing pharmaceutical care trajectory between hospitals and community environments for elders (primary objective).

  • Identify human resources needs in a pharmaceutical care trajectory.

  • Document pharmacotherapy problems (indication, efficiency, safety, and adhesion) and the interventions that are carried out to manage them.

These objectives are achieved thanks to all the stakeholders’ collaboration. Since September 2018, 90 patients have been participating in the research project. As a matter of fact, the network healthcare professionals record their patient data in a collaborative tool. Omnimed allows them to collaborate to reach a common goal: offer personalized and adapted treatments.

 

17 community and hospital pharmacists

90 patients participating*

16 general physicians

 

A powerful network

Different information sources are consulted in that research project including the drugs list from the patient’s pharmacy, the clinical information from the Quebec Health Record (QHR) and the medication profile in the EMR. This way, when a patient is admitted to a hospital, the hospital pharmacist meets him if he meets the research criteria (problems and medications such as 15 or more). A consent form is then signed if the patient accepts to participate. A copy is given to the patient and one is saved in his file. The hospital pharmacist then completes the MedRec and writes a pharmaceutical care trajectory in Omnimed. This useful plan is updated by the community pharmacist and the general physician when the patient is discharged from the hospital. It’s worth gold as they usually don’t have access to that much clinical data in one tool. Beyond the treatments, this collaboration, which abolishes traditional physical obstacles, allows them to offer personalized care. This complete patient file overview allows the community pharmacist and the general physician to be more efficient and becomes a fantastic lever for their respective involvement.

Furthermore, the patient’s general physician and the pharmacists can join a geriatric medicine specialist, Dre Geneviève Ricard. This collaboration is possible thanks to electronic consultations which allow them to get answers to their ambiguous or complex questions. Thus, all of the healthcare professionals treating the patient since his first hospital admission have access to the clinical data saved in their EMR so the network can have in hand a complete patient file.

Only the Clinique Médicale Memphré had already used Omnimed before the launch of the project. The new licences have been generously granted by Omnimed.

This research project couldn’t have been that synergistic without the involvement of the researchers, the Clinique Médicale Memphré, the Clinique Médicale du Lac, the hospital pharmacists and the community pharmacists from Magog area.

*March 29, 2019
 

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