The Challenge

It is estimated that 1 in 15 hospital admissions are a result of avoidable harm from medicines and poor medicine management is a contributor to this avoidable harm. The financial burden this puts on the NHS is estimated to exceed £1bn a year. These challenges are particularly evident in the care home setting where there is high scrutiny from regulators of care homes. Invatech’s PCS software is designed to reduce medication errors that contribute to these statistics. However, the total solution also needs to consider the choice of hardware to ensure that it is fit for purpose for the care home setting. The first generation of Invatech’s PCS system was offered to care homes on a Psion handheld device. The handheld device had various problems including a short battery life, difficulty in scanning and a small screen. For the second generation of the PCS software, Invatech researched the device market to provide an advanced solution for medicines management in care homes. Specifically, the device needed to have an Android platform with an integrated barcode scanner. The device needed to be rugged and have an anti-microbial coating. The docking station needed to have an Ethernet port for connectivity.

The Solution

Invatech vigorously tested a variety of healthcare tablets using a range of methods from drop tests to waterproof tests; the MioCARE™ A105 was chosen for its durability, drop and splash resistance and its long battery life. MiTAC also worked with Invatech in providing a custom ROM update to Android to allow the PCS software to be more effective. The second-generation PCS on the MioCARE™ A105 solution was then trialled in a real environment and introduced into Lakeview - a 200 bed care home in the Midlands. The trial at Lakeview was extremely successful, enabling a more secure and seamless medication management process. Below are the results from the Lakeview Care Home roll out:

• There was a substantial reduction in the record keeping errors and over 1000 safety alerts were flagged per week
• The ergonomic design of the tablet better suited the areas and nurses, with the larger screen providing better legibility of resident medication details and on-screen error warnings.
• Battery life on the device was excellent, with the support of the charging cradle allowing 300 administration/barcode scans per day per device
• Carers found that they had more time to provide care to elderly residents because of efficiencies in medicines management with the PCS on the MioCARE™ A105

After extensive evaluation of devices and the real environment trial in Lakeview, MiTAC was chosen to partner Invatech in delivering the PCS system for a Welsh Government Funded project involving 30 care homes in South Wales. The project provided £450k through the Health Technology and Telehealth fund and aimed to evaluate the impact of introducing electronic medicines management in care homes. Cardiff University carried out an independent evaluation of the system which was published in November 2015. The evaluation showed the following impact:

• There are 23 distinct error types relating to medicines administration and accountability and residents are exposed to between 24 to 48 errors per week
• After the implementation of the PCS on the MioCARE™ A105 device, 21 out of the 23 error types were eradicated and the two remaining errors were significantly reduced
• Prior to the implementation of the system waste associated with returned medicines was estimated to be £19.01 per resident per month and over stock of medicines in the care home was estimated to be at £20.25 per resident per month
• Post-implementation there was a 55% reduction in medicines returned and a 22% reduction in over stock. Extrapolated across Wales, these figures would represent a potential annual saving of up to £4.6 million
• The usability of the PCS system on the MioCARE™ A105 was also evaluated and found very favourable with 96% of care homes in the study wishing to continue and would not wish to return to paper based systems.

The Outcome

Since the partnership began in 2014, the complete solution has gone from strength to strength. Care homes across the country were extremely happy with the PCS system on the new devices and the overall increased efficiency and error prevention. They were now able to administer the right medicines to the right resident at the right time; if a nurse attempted to give medication inappropriately, the PCS would provide an error message and not allow this to happen. On average, the PCS made eight interventions per resident per month. Care homes now also have increased accountability and can performance manage staff and evidence compliance with their regulations.

MioCARE™ A235

At the start of 2017 there are approximately 550 MioCARE™ tablets across the country operating the PCS system in around 250 care homes. The MioCARE™ A105 devices that were used in 2015 have been upgraded to the MioCARE™ A235 with even faster processing and better barcode scanning.