North West Telepharmacy and FirstHx partner for remote BPMH solution

Hospitals across Canada face increasing challenges in ensuring the quality of care they provide, particularly when it comes to medication reconciliation. A key component of medication reconciliation is conducting a Best Possible Medication History (BPMH) to ensure a patient’s medication information is accurate.

After an effective BPMH, all decisions concerning medication used in hospital can then be made with the necessary information about what the patient was using prior to admission.

The whole medication reconciliation process has been a Required Organizational Practice (ROP) in Accreditation Canada’s standards for over a decade. However, many hospitals struggle to meet that standard.

North West Telepharmacy Solutions (NTS) now offers a virtual BPMH and medication reconciliation service that hospitals can subscribe to as they need it. This innovative program leverages remote pharmacy technicians and advanced software to improve the accuracy of medication reconciliation, instilling confidence in the system.

In small hospitals, where staffing is often limited, pharmacy personnel are not always available to conduct a BPMH. Additionally, recruiting registered pharmacy technicians to fill these gaps has proven difficult, especially in rural and remote areas of Ontario.

This shortage places a significant burden on emergency room (ER) nurses, who are often tasked with conducting BPMH on top of their already demanding roles; putting a complex and time-consuming extra responsibility on already busy nurses leads to frustration and less accurate results.

“Many hospitals simply don’t have the pharmacy personnel and certainly don’t have pharmacy staff available in the evening when many patients are being admitted. Leaving nurses with the additional responsibility to conduct a BPMH is an unrealistic expectation,” said Kevin McDonald, director at NTS. “Our program helps alleviate that burden while ensuring high-quality, standardized medication histories are still collected.”

NTS has responded to these challenges by creating a remote BPMH program that relies on pharmacy technicians employed directly by the company. These remote pharmacy technicians work with hospitals to conduct BPMH interviews via videoconferencing or phone calls.

This approach ensures that patients still receive the care and attention needed for accurate BPMH while freeing up ER nurses to focus on their primary duties. The flexibility in communication methods allows the program to adapt to the varying capabilities of the hospitals it serves.

“By having our remote pharmacy technicians conduct BPMH, we allow hospital staff to focus on their clinical roles, while we ensure accurate medication information is obtained,” explains Rebecca Lynch, NTS pharmacy technician supervisor.

One of the standout features of NTS’s BPMH program is its partnership with FirstHx, a software company that has co-developed a tool specifically designed to streamline the BPMH process. The FirstHx tool, MedHx, is based on the ISMP Canada algorithm, ensuring that BPMH interviews are conducted in a standardized manner, improving accuracy and reducing variability between interviews.

What sets the MedHx tool apart is its ability to prompt patient-specific questions during the BPMH interview. The tool starts with basic questions about the patient’s medications but dynamically adjusts the line of questioning based on the patient’s responses.

This ensures that important aspects such as allergies, smoking habits, alcohol use, and substance abuse are captured. Additionally, it can delve deeper into clinical questions related to specific disease states such as diabetes or congestive heart failure, a feature that is typically outside the scope of a standard BPMH interview conducted by a pharmacy technician.

“The MedHx tool is truly a game-changer. It not only simplifies the BPMH process but also ensures that we gather critical information that might otherwise be missed,” noted Sammu Dhaliwall, senior manager for Business Development, Research and Health Innovation at NTS. “The tool’s ability to adapt to the patient’s medical condition is something we haven’t seen in other BPMH solutions.”

Once the interview is complete, MedHx generates a summary document that can be easily integrated into the hospital’s information system. This document provides a clear and concise record of the patient’s medication history, which is readily accessible to other healthcare professionals involved in the patient’s care, making it easier to review and utilize for medication reconciliation.

“I am very excited for what’s to come for MedHx,” commented Dr. Chris O’Connor, CEO at FirstHx. “It revolutionizes medication profiles by providing a precise digital medication list that saves time, boosts efficiency, and reduces errors – paving the way for safer, more efficient med profiles in every healthcare setting.

In the future, NTS and FirstHx plan to develop the program further by allowing patients to complete the BPMH tool while they wait in the ER or before pre-operative appointments. This will expedite the process and improve the accuracy of the information gathered by engaging patients directly.

Although still in its early stages, NTS’s remote BPMH program has already shown promising results. An informal pilot conducted at a small hospital in Northern Ontario demonstrated that using FirstHx and remote pharmacy technicians significantly improved the standardization of BPMH interviews.

The feedback from hospital staff has been positive, particularly in terms of the useful and detailed information that the pharmacy technicians can gather and communicate to pharmacists and other clinical team members.
“The results from our pilot program were encouraging, as we saw clear improvements in both the quality and efficiency of the BPMH process,” said Dhaliwall.

Looking ahead, NTS plans to expand the program to the more than 100 hospital clients it currently serves across Canada. By doing so, the company hopes to not only address the resource challenges faced by hospitals but also to improve patient safety on a national scale.

This innovative approach is a prime example of how technology and telepharmacy can work together to solve real-world problems in healthcare, ultimately benefiting both patients and healthcare professionals.