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Closed-Loop Medication Management with an Electronic Health Record System in U.S. and Finnish Hospitals

Author

Listed:
  • Susan B. Shermock

    (Howard County Medical Center, The Johns Hopkins Health System, Department of Pharmacy Services, 5755 Cedar Lane, Columbia, MD 21044, USA)

  • Kenneth M. Shermock

    (Center for Medication Quality and Outcomes, The Johns Hopkins Health System, 600 North Wolfe Street Carnegie 180, Baltimore, MD 21287, USA
    Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, 00029 Helsinki, Finland)

  • Lotta L. Schepel

    (Quality and Patient Safety Unit and HUS Pharmacy, HUS Joint Resources, Helsinki University Hospital and University of Helsinki, 00029 Helsinki, Finland)

Abstract

Many medication errors in the hospital setting are due to manual, error-prone processes in the medication management system. Closed-loop Electronic Medication Management Systems (EMMSs) use technology to prevent medication errors by replacing manual steps with automated, electronic ones. As Finnish Helsinki University Hospital (HUS) establishes its first closed-loop EMMS with the new Epic-based Electronic Health Record system (APOTTI), it is helpful to consider the history of a more mature system: that of the United States. The U.S. approach evolved over time under unique policy, economic, and legal circumstances. Closed-loop EMMSs have arrived in many U.S. hospital locations, with myriad market-by-market manifestations typical of the U.S. healthcare system. This review describes and compares U.S. and Finnish hospitals’ EMMS approaches and their impact on medication workflows and safety. Specifically, commonalities and nuanced differences in closed-loop EMMSs are explored from the perspectives of the care/nursing unit and hospital pharmacy operations perspectives. As the technologies are now fully implemented and destined for evolution in both countries, perhaps closed-loop EMMSs can be a topic of continued collaboration between the two countries. This review can also be used for benchmarking in other countries developing closed-loop EMMSs.

Suggested Citation

  • Susan B. Shermock & Kenneth M. Shermock & Lotta L. Schepel, 2023. "Closed-Loop Medication Management with an Electronic Health Record System in U.S. and Finnish Hospitals," IJERPH, MDPI, vol. 20(17), pages 1-14, August.
  • Handle: RePEc:gam:jijerp:v:20:y:2023:i:17:p:6680-:d:1228621
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    References listed on IDEAS

    as
    1. Jeffrey K. Aronson, 2022. "Artificial Intelligence in Pharmacovigilance: An Introduction to Terms, Concepts, Applications, and Limitations," Drug Safety, Springer, vol. 45(5), pages 407-418, May.
    2. Kirsi Kvarnström & Ilona Niittynen & Sonja Kallio & Carita Lindén-Lahti & Marja Airaksinen & Lotta Schepel, 2023. "Developing an In-House Comprehensive Medication Review Training Program for Clinical Pharmacists in a Finnish Hospital Pharmacy," IJERPH, MDPI, vol. 20(12), pages 1-12, June.
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