Department of Pharmacy, Taichung Veterans General Hospital, Taichung, Taiwan.
Department of Clinical Informatics Research and Development, Taichung Veterans General Hospital, Taichung, Taiwan.
Int J Med Inform. 2019 Jun;126:65-71. doi: 10.1016/j.ijmedinf.2019.03.012. Epub 2019 Mar 20.
To develop and implement an integrated cloud technology with the aim of ensuring medication reconciliation during transitions of care and improve medication safety in aged societies.
PharmaCloud is a new technical platform adopted by the National Health Insurance Administration of Taiwan to collect patients' medication information via cloud technology. Using this platform, healthcare providers can access patients' medication-related information with patient consent. Our hospital applied this technology and developed several approaches to collect and detect medication-related information and alert physicians for the purpose of enhancing patients' medication safety. In addition, pharmacists were involved in the admission process to access medication data and provide optimal suggestions to physicians. Several indicators, including a reduction in the number of drug items in each prescription and medication expenditure, were employed to evaluate the overall effects of the cloud inquiry.
After the application of PharmaCloud, the average number of prescribed drug items significantly decreased (change of 0.04 to -0.35 per prescription, p < 0.05), and the median medication expenditure significantly decreased by an average of 3.55 USD, (p < 0.05) per prescription. Intra-hospital medication duplication rates also showed a downward trend.
The use of the cloud technology and value-added applications significantly improved patient medication safety. Further long-term beneficial effects in terms of medication safety and medical cost savings are expected.
开发并整合云端技术，旨在确保患者在医疗转衔期间的用药一致，并提升老龄化社会的用药安全。
云药通（PharmaCloud）是台湾全民健康保险署采用的一项新技术平台，通过云技术收集患者的用药信息。通过该平台，在获得患者同意的情况下，医疗服务提供者可以访问患者的用药相关信息。我们医院应用了这项技术，并开发了几种方法来收集和检测用药相关信息，并向医生发出警报，以提高患者的用药安全。此外，药剂师参与入院流程，以获取用药数据并为医生提供最佳建议。我们采用了几个指标，包括每张处方的药物种类数量减少和用药支出减少，来评估云端查询的总体效果。
应用云药通后，每张处方的平均用药种类显著减少（从 0.04 减少至-0.35，p<0.05），用药支出中位数平均减少 3.55 美元（p<0.05）。院内用药重复率也呈下降趋势。
云端技术和增值应用的使用显著提高了患者的用药安全。预计在用药安全和节省医疗费用方面会有更长期的有益效果。
