Optimising medication use in the Emergency Department (expired)
Value-based care is increasingly important within Health Services, including in the Emergency Department (ED) environment. The concept of value-based care broadly encompasses balancing the benefits of treatments provided to patients with the financial costs of the treatment. An essential component of the delivery of value-based healthcare in the ED is increasing clinicians’ understanding of the full costs and benefits of the treatments provided to patients and the alternate options available.
In a field where advances in medical knowledge are made frequently, constant change is required to improve the care being provided to patients presenting to the ED. In order to provide the most appropriate and cost effective patient care, clinicians must have ready access to information for the broad range of illness and injury seen within EDs.
Poor communication and difficulty with access to new treatment information due to the nature of the ED environment, coupled with a lack of awareness about the economics of healthcare have been identified as barriers to increasing the visibility of value-based healthcare. These issues contribute to the difficulty in undertaking successful behavioural change initiatives in EDs.
A solution is sought that provides ready access to the information necessary for an ED clinician to create long-term, sustained change based on evidence and feedback with an awareness of value-based healthcare. Reductions in overall prescribing costs and variations in patient care will ensure that ED physicians can continue to provide high quality care in a system where resources are limited, and demand is increasing.
Solution design parameters
A solution to this challenge will need to drive behaviour change in the ED by helping ED clinicians quickly digest and understand new knowledge and apply that knowledge to their local context and clinical decisions. This challenge is focused on changing prescribing behaviours, to help clinicians make better informed, value-based decisions about medication prescription without compromising patient care.
The successful solution will need to work within the following technical considerations:
- sufficient flexibility to deal with a wide variety of treatments that can be provided in an ED
- to remain locally relevant and tackle key priorities of specific EDs
- provides aggregated (e.g. departmental-level) feedback to clinicians without scrutinising the prescribing and treatment practices of individuals
- should not increase overall workload of ED staff
- scalable and flexible
- give consideration to differences in preferred communication styles of staff
- high level of security and confidentiality of patient data, ideally by avoiding patient-level information
- highly mobile for use in ED environments, without introducing any new occupational hazards.
Additionally, it is expected that information communications technology (ICT) solutions comply with any relevant standards (such as Health Level-7 (HL7), Fast Healthcare Interoperability Resources (FIHR) and WebServices) and be compatible with MNHHS’ existing ICT systems.
The successful solution will need to demonstrate the following benefits:
- appropriate, engaging and efficient communication with a focus on driving behavioural change in the ED
- streamlined presentation of relevant information from existing clinical, academic and administrative sources, including information on:
- new evidence about health care treatments
- the current use and costs of medications
- the effectiveness of medications (or other change) initiatives
- ability for clinicians and pharmacists to create and input content regarding best practices in prescription and treatment
- immediate feedback on medication prescribed (at the department level), relating to efficacy, cost and better value options
- relevant data that is easily extracted in a timely manner to support behavioural change
- allow for the extraction and presentation of data to provide increased visibility of the benefits of behavioural change and allow success to be celebrated (for example, by changing this behaviour, $X has been saved, allowing for Y to take place).
- highly searchable, to allow clinicians and pharmacists to access information quickly
- improve decision support, possibly by incorporating machine learning capability .
Additionally, there may be an opportunity for a solution to make use of data drawn from the Pyxis MedStation System, an automated medication dispensing system. This system collects accurate and precise data on the usage of all medications used in the ED (both volume and types of medications), and can provide real-time stock usage reports.
Although this challenge is focused on driving change in prescription behaviour, there is the potential for the successful solution to be applied to behaviour change more broadly in the ED and in other Health sectors in future. Other areas where variability in clinical practice may be addressed include radiology and pathology ordering practices.
Terms and conditions
The Small Business Innovation Research (SBIR) aims to provide commercial opportunities for applicants, while at the same time, solving Queensland Government challenges via an innovative procurement process.
Successful applicants will receive funding to research, develop and test their idea. At the end of the process, applicants have the potential to secure a contract with the Queensland Government. Additionally, intellectual property developed within the SBIR is retained by the party who developed it, allowing applicants the potential to access broader commercial opportunities.
Further terms and conditions can be found here.