How is ATLAS eMAR a Mobile Solution at Point of Care?

Introduction
Invatech Health’s ATLAS eMAR system operates on an android mobile tablet device model A505 by Miocare. The choice of device to support ATLAS eMAR is very important to enable ease of use and point of care. The technology is captured in sleek hardware allowing integration with pharmacy to prompt effective medicines management, thus producing statistically significant time savings compared to traditional paper MARs for each process and in terms of the overall time devoted to medicines management.

Here, we provide an outline of how ATLAS eMAR is a Mobile Solution at Point of Care, how our unique eMAR solution prompts alarms and alert escalations, and how our unique technology prompts and supports a Robust Audit Trail.

In a Cardiff University technology evaluation, ATLAS eMAR has been evidenced as saving an average time of 65.5 hours per care home per month. The greatest percentage reduction in time using the ATLAS eMAR was for the process of auditing medication administration records (72%) followed by the process of checking prescriptions have been issued (66%), the new monthly supply changeover process (65%), the booking-in of medicines (64%) and monthly ordering of prescriptions (62%). Time efficiencies using ATLAS eMAR saves an average of 30%.

ATLAS eMAR - Total Mobile Solution
The following features of the device are very important considerations: 1) In-built barcode scanner. The safety of ATLAS eMAR system relies on barcode scanning of medicines at the point of administration. The built-in scanner for the mobile device means that staff can operate the system with one hand and bring the device close to the person; 2) polycarbonate disinfect-able surface coating allows full wipe down; 3) 5.8” sleek touch screen that allows all information to be displayed, transparently; 4) SD micro card that records all information regarding administrations; this means that no internet is required at the point of administration, saving time.

In the rare event that the device needs to be swapped out, the SD card is inserted into a new device and the data is preserved, so you can rest assure that there will be no data loss or improper data handling; 5) Rear facing camera enables photos of the resident to be taken and regularly up-loaded on to resident’s profile; 6) Battery life of 6-hours. This is usually plenty of charge to complete medicines administrations. However, there is the facility to swap out batteries on hardware in the circumstances where there is not enough charge to complete the round; 7) ATLAS eMAR is Wi-Fi enabled via Miocare hardware to prompt synchronisation and swift exchange of information. In addition, a hard-wire internet connection is also available via a cradle docking station. The Miocare is dust proof and awesomely robust; such key features are important in context of medicines management in care and nursing homes.

ATLAS eMAR and Point of Care
The ATLAS eMAR is ground-breaking technology and provides all the information required to allow medicines administration at the point of care. The intuitive technology has been created, not just to meet the overwhelming concerns in traditional paper MAR errors in care and nursing homes but is also technology that meets security and ISO standards. ATLAS eMAR technology includes: 1) details of administrator; 2) Details of administration over the last 14 days; 3) Records of all stock movement over the last 14 days; 4) Records of all prescription requests and the status of these; 5) Images of all prescriptions and 6) Medicines Stock levels.

ATLAS eMAR Alarms and Alert Escalations
The safety of the system is dependent on barcode validation of instruction labels at the point of medicine administration. If the wrong medicine is scanned the following checks are made and alerts are displayed on the device: 1) Wrong resident – medicine belongs to another resident; 2) Medicine not due – the medicine is not due at this time; 3) Too soon – intervals between dosages have not been observed; 4) Medicine stopped – the medicine is not an active therapy; 5) Barcode not recognised – manufacturer’s barcode scanned instead of instruction label; 6) Alert to indicate that the wrong quantity of medication is about to be administered.

In addition, the following alerts are also displayed at the point of administration or at the appropriate workflow process: 1) Low stock: medicine supplies have reached 9 days or less; 2) Stock take required: scenarios where stock levels are likely to be wrong; 3) Unaccounted medicines: medicines are due for administration but not accounted for; 4) Drug changes: there has been a change in therapy in the last 24 hours; 5) Witness required: scenarios where a witness is required for example for administrations of controlled drugs; 6) Allergy warnings are displayed if a medicine is attempted to be added and the resident’s notes indicate an allergy; 7) Missing administration; 8) Medication attempted but not given – this ensures staff are aware of these medicines and do attempt to give the medicines again. There are three methods of escalation of the alerts:

On the device, some of the activities are displayed in lists so that they can be addressed at shift handovers. For example, missing administrations and medication attempted but not given and low stock warnings. A daily report is emailed to care home managers with the details of some of the alerts. Prompts enable the manager to act – some can include a) Medication not administered regularly; b) Missing entries; c) Stock takes; d) Low stock items; e) Barcodes not scanned.

ATLAS Scorecard provides a score for medicines management across a single care home or several homes. This score is made up of several measures that relate to the alerts including “missing entries” “low stock” “Witness required”. Managers can view performance in each of these measures and drill down further to resident and staff levels.

ATLAS eMAR Supporting Robust Audit Trail
ATLAS supports robust audit based on four principles: 1) Individual log on details for all users of the care home device, CAPA pharmacy system and ATLAS Central; 2) Recording of all medicines related activities and time stamping these with the user, date and time; 3) Sharing of information between the pharmacy and care home system; 4) Making the data available in the form of reports, escalated emails and scorecards. These principles allow the robust audit, investigation and improvements in all the processes of medicine management across the care home, pharmacy and the surgery. For example, the whole medicine journey can be traced and audited including:

• Details of the stock levels that prompted a prescription request, who made the request and what time and date
• When the prescription request was printed to be forwarded to the surgery
• When the pharmacy started receiving the prescriptions and the images of these
• When the details were inputted and by whom
• Which medication were checked and changed and by whom?
• Which individual pack of the medicine was labelled and packaged?
• When the medicines were delivered to the care home
• Outstanding prescriptions not issued by the surgery
• When the care home booked in the medicines and by whom
• When the medicines were administered or accounted for and by whom
• The quantities of medicines returned, when and by whom

The reports and scorecards allow easy access to the information at each of the processes. Care home managers and staff are supported through the audit facilities through training and by ATLAS account managers.

Keep an eye out for Invatech's follow up news on ATLAS eMAR Dashboard, Archiving and Retrieval Processes (Part 4).

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Invatech Health Ltd

442-450 Stapleton Road
Bristol
BS5 6NR

Tel: 0117 2140315
Email: info@invatechhealth.com

Invatech Health Ltd is a company registered in England and Wales. Registered number: 08972421. Registered office: 442-450 Stapleton Road, Bristol, BS5 6NR. VAT Number: 184392679.