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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
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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.