BCMA @ HSCQC, January 9, 2012 BAR CODED MEDICATION ADMINISTRATION (BCMA) UM-CareLink BCMA Solution Implementation Projects Project A: Bi-directional interface activation Project B: Implement bar code medication scanning Medication Use Process Errors and Bar Code Scanning Impact and Prevalence of BCMA • Poon, et al. : Observed 14,041 medication administrations and reviewed 3082 order transcriptions. 11.5% error rate without BCMA vs. a 6.8% error rate when BCMA used — a 41.4% relative reduction in errors (P<0.001). T • The rate of potential adverse drug events (other than those associated with timing errors) fell from 3.1% without the use of the bar-code eMAR to 1.6% with its use, representing a 50.8% relative reduction (P<0.001). • Morriss results in the neonatal ICU: A total of 92 398 medication doses were administered to 958 subjects. The BCMA system reduced the risk of targeted, preventable ADEs by 47%, controlling for the number of medication doses/subject/day. • 2011 ASHP survey of 1401 hospitals: 50% of hospitals have adopted BCMA and 66% of hospitals > 600 beds have adopted BCMA. CURRENT STATE: Cannot Scan UM-CareLink Medication Order Messages Pharmacy Verification Signal Only Open Loop 4 PROJECT A: Activate Interface UM-CareLink Medication Order Messages Pharmacy Closed Loop Verification & Dispensed Product Information PROJECT B: Implement Scanning 6 Image from: http://www.stjohns.com/news/images/mercymeds.jpg Success Factors Fix known interface issues Address UMCL 5.5 upgrade/Windows7 dependencies Overcome internal resource competition Identify and assign necessary specialists Productive vendor relationships Enterprise-wide commitment to BCMA Projects A & B: Incremental Budget Needs Original Capital $1.95M Funds Remaining Equipment to Purchase Available $300K MCIT $200K Scanners $100K MCIT $150K Nursing $150K Nursing Additional Incremental (New) Costs Estimates* $210K + $250K - $100K = $360K Labor MCIT $20K + $200K - $150K = $70K Labor Nursing $50K + $25K = $75K Labor Pharmacy $60K + $0 = $60K Server/Hardware $80K + $60K = $140K Vendor Services *Pending refinement and finalization of actual additional capital request High level time-line & sequence BCMA Project A, Interface: 7 Months Feb ‘12 Sep UM-CareLink 5.5 Upgrade Jan ‘12 Sep BCMA Project B: Nurse Scanning Roll-out 6 Months Nov Jan ‘13 Pilot Apr ‘13 Trade-offs – BCMA in 2012 means deferring these: + WORx pharmacy system upgrade + eMAR interface to TheraDOC + Rx IV room bar-code scanning system + Now & Then CPOE (600mg now & then 300mg BID) + Insulin CPOE enhancements + Controlled substance CPOE enhancements + Restricting use of “as directed” in CPOE We have the capacity for BCMA in 2012 + Nursing staff ready to support project + Pharmacy staff ready to support project + Medication-use system IT experts ready + Plan for Quality Assurance & Interface engineers BCMA would continue alongside UM-CareLink 5.5 Upgrade & along with building up the MiChart pharmacy team.