© 2005 Medixine Oy

Piloting a Multimodal Medication Management System

Tapio Jokinen, M.D., CEO

Medixine Ltd

www.medixine.com

© 2006 Medixine Oy

Medixine

• Medixine is a software company

• Our product is a multimodal communication software suite

• Our customers are healthcare providers, insurance companies, pharmacies, pharmaceutical companies

• Over 200.000 users in 16 countries

© 2006 Medixine Oy

Health care provider

Patients/caregivers/customers

Communication platform

eBooking Measurements Counselling Messaging Queries

© 2006 Medixine Oy

The Strategy

Vertical - Horizontal

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MEDIXINEGeneric communication solution

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© 2006 Medixine Oy

Medixine Functional Modules

Medixine Application Server Software

AdditionalMedixine/third-party

Webmodules

Patient management

systems

Medixine Solutions

XML

Bluetooth

© 2006 Medixine Oy

PatientPortal

Family

Friends

Home care

Professionals

Social services

PharmacyNutrition

Medication

Patient

© 2006 Medixine Oy

Sample Solutions

• Medication management• RFID logging• RFID Communication board• Automatic Treatment Follow-up• Chronic Disease Support Network• Chronic Disease Clinic• Mobile data collection• Occupational Health Card• Citizen’s Interface• Laboratory e-booking• Hypertension, diabetes, warfarin treatment ...

© 2006 Medixine Oy

Pilot in Helsinki City Homecare

• Piloting a full logistic solution including pharmacies

• 400 patients planned, ca. 100 enrolled, pilot now extended and area expanded

• Co-operation between public and private sector

• Pilot evaluated by STAKES

National Research and Development Centre for Welfare and Health

© 2006 Medixine Oy

Background to Pilot

• Medication related tasks take up to 20% of nurses’ active work time

• ”33% of the medication is taken as prescribed, 33% is taken some times and 33% not at all”

• Elderly patients forget, take incorrect doses• Medication related problems substantial

reason for hospitalisation• Invest saved nursing time and better quality

of care into activating patients -> postpone hospitalisation ?

© 2006 Medixine Oy

Drug Dispenser

• Ensures correct medication management• Gives out only the correct dose

– beeps reminders if dose not taken in time– transmits a remote alarm if dose remains not taken

• Skips possible not taken doses that remain safely inside the dispenser

• User definable 1, 2, 3 or 4 daily dose times– 14 compartment cassette for big 1 or 2 daily doses – 28 compartment cassette for small doses– 21 compartment cassette for 3 doses a day use

© 2006 Medixine Oy

Reminders, alerts

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Mobile alert

Reminder

Alarm Alarm

Patient

Family

Nurse

© 2006 Medixine Oy

Patient Portal

• For patients, their families, nurses, doctors, pharmacies

• Records compliance, alerts, reminders

• Uses web, SMS, IVR, unlimited number of recipients

• Shows reports• Allows for additional e-services

to be used (next: patient monitoring, mobile nurse)

• Generic substitution• Information about medication,

integration to pharmaca

© 2006 Medixine Oy

Medication Logistics

• Pharmacy managed medicine logistics

• Cassettes packed at pharmacy, marked with sticker

• Dispensed mediciation documented to patient portal

• Supplied to nurses’ offices

• Nurses bring patient’s cassette when visiting patient

• Nurses change cassettes at patient’s home

• Empty cassette back to nurses’ office

• Pharmacy picks up empty cassettes

© 2006 Medixine Oy

A usability survey with two purposes

• Surveying the conventional medicine delivery service process currently in use.

• Identifying the benefits and disadvantages of the new medicine delivery service process compared with the conventional one, with an emphasis on the client’s perspective, as well as on medicinal and information technology considerations.

National Research and Development Centre for Welfare and Health

© 2006 Medixine Oy

Evaluation

• Surveying the conventional medicine delivery service process currently in use, 10 delivery models found

• Surveying the new medicine delivery service process• Identifying the benefits and disadvantages of the new

medicine delivery service process compared with the conventional one, with an emphasis on the client’s perspective, as well as on medicinal and information technology considerations.

• Results to be published Q1/2007

© 2006 Medixine Oy

Questions to Answer

• (1) How functional is the current action model from the perspective of the client, staff time use and related costs, and medicine dispensing (accuracy/wastage)?

• (2) What are the benefits and disadvantages of the current action model?

• (3) How will the new process of medicine delivery service change the operations from the perspective of the client, staff time use and medicine dispensing?

• (4) How well does the new process of medicine delivery service function from the perspective of the usability of information technology?

• (5) How will the change affect the clients’ and family members’ experiences?

• (6) How will the introduction of the new service model affect the staff’s experiences of professionality, co-operation with pharmacies and the interaction between home-care clients and staff?

• (7) How will the new action model and information technology change the work duties of the home-care staff?