Developing an Electronic Medications Administration Record System

It is estimated that every year preventable inpatient medication errors result in over 4 million patient readmissions, 7,000 deaths and carry a staggering cost of $21 billion. 

To mitigate this problem, one of the largest Healthcare institutions in the USA implemented an EMAR system and deployed it to its primary hospitals. 

The EMAR facilitates a ‘closed-loop’ system: an end-to-end electronic medication management with a seamless flow of information throughout the process – from creation of a medication order, to Rx processing and distribution, to delivery to the right patient. 

Over a period of eight years, our team worked with clinicians, hospital administration and IT personnel on the design, implementation, and subsequent maintenance of the EMAR system. This large-scale project required extensive changes to existing processes and workflows, and technological enhancements to the existing systems. 

It is estimated that deployment of the EMAR system has reduced the cost of medication errors by $25,000 per day – in just one hospital. 

The Challenge 

The EMAR brought together and communicated with just about every other major inpatient system in the hospital ecosystem including Order Entry, Pharmacy, Discharge, Common Data Repository and others. It transformed existing workflows and introduced new processes for nurses, pharmacists, physicians and hospital administrative staff. It required deployment of new technology infrastructure that included portable nursing stations and bar code scanners as well as bar code labeling and repackaging of drugs in the inpatient pharmacy. 

Our technical team was involved in the design and development of the entire system as well its major components from early on in the process to its production deployment and support. We’ve worked on several iterations of the system on different software and hardware platforms and facilitated its integration with other systems. 

Transition from a single-hospital system to Enterprise EMAR created its own set of challenges. As part of the joined team from several institutions and corporate IS we had to develop a data model and create unified processes that supported the needs of the Enterprise without disrupting an already working deployment of the EMAR system in the first hospital. 

The Outcome 

The EMAR system has gone through a sequence of successive production rollouts over a period of 8 years. Our client believes that the Electronic Medication Administration Record system in combination with bar code technology completely transformed how nurses administer medications. The EMAR system has vastly improved the management and tracking of patient information, and it ensured that nurses deliver the right medication at the right dosage to the right patient at the right time. 

The EMAR system has also proven to be highly effective for reducing administration errors. The management of the hospital has estimated that the new system has reduced the rate of medication errors by 41%. 

The Technological Stack 

InterSystems Cache, Ensemble, Objectscript, .NET, C#, MVC, Javascript, Ajax libraries

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