The three Auckland District Health Boards (DHBs), Auckland District Health Board (ADHB), (WDHB), and Counties Manukau Health (CMH) serve a population of around 1.6 million people. At any point in time, there are approximately 23,000 service users open to Mental Health and Addictions services across the Auckland metro region.
In 2016, the DHBs made the decision to implement the use of the New Zealand Universal List of Medicine (NZULM) across all DHB services. The challenge for Mental Health and Addictions services, including the Regional Mental Health Forensics and Alcohol and Drugs Service, was that the drug formulary that has been used for recording and prescribing medicines in the single instance Auckland metro regional electronic medical record, ‘HCC, since 2009 has been MIMS.
The Challenge
The issue of replacing the formulary would impact on 83,633 existing prescriptions in the clinical records that would need to be converted to the new formulary. The challenge relating to clinical users who would be prescribing medicines would be to provide a process that was straight forward and easy to adapt to using NZULM as the dictionary and the NZF webservices.
The Solution
By working collaboratively with the vendor, who was based in Canada, we were able to identify our expected requirements to bulk-update the most commonly prescribed medicines from MIMS to NZULM. We also described scenarios for the preferred workflow for clinical users to be able to discontinue previously prescribed medicines and replace or re-prescribe these in NZULM with as little impact as possible to users and service users.
The vendor would make available the latest functionality to us that they had tested in their QA environment, which we would then test in our environment with the volume of data that was in our system. We would then feedback to them and they would enhance or re-build it to better suit our needs. At times team viewer sessions were a useful way to demonstrate how the functionality behaved given our particular configuration and workflow.
We engaged medical staff in discussion regarding the plan to make the switch and kept them updated of progress.
Using the interactive collaborative method for describing and examining the issues that presented during the development phases resulted in a ‘fit for purpose’ solution.
What makes us unique?
We are unaware of any other service that has the volume of prescription data already within their records that has had to replace the formulary with another one and where the relationship with the vendor has enabled such a smooth transition.
