One of our team members is a nurse turned programmer, so during the topic presentations he immediately warmed to the idea of the medication reconciliation topic. This team member, Zach, understood that this problem is severe and that no hospital or doctors office is without these challenges. This first-hand knowledge was the driving factor behind our decision.
After speaking with Wayne Floyd and Julie Woodruff we decided that the issue of medication reconciliation had five "pain points" that needed to be addressed:
-Physician Offices and hospitals entering prescription data. -Many different pharmacies that the patient can use to fill a prescription. -Knowing that the patient received the prescription. -Knowing that the patient is actively taking the medication. -Getting this information to physicians and hospitals before or during the patient's next visit.
We built a solution that can solve all of these problems. Our app has integrated with Epic, an electronic medical record system utilized by St. Francis and many other hospitals across the United States. We have also provided a frontend that is written in the Angular framework that can facilitate this data entry for hospitals that utilize other medical record systems.
The pharmacy component is another angular frontend for data entry, however, we have also provided a listener service that can be utilized to "listen" the pharmacy's local database and update our system when prescriptions are received, filled, and picked up by the patient.
We have provided a mobile application that is written in the Ionic framework, so it compiles to both Android and iOS, for patient end-use. This application will notify the patient when their prescription has been received by the pharmacy or filled by the pharmacy. The application also provides the patient with the details of their prescription such as dosage, frequency and the route for taking the medication. The patient can also set up push notifications to notify them when to take the medication and will provide this usage or denial data to the physician. So for example, if the patient is having adverse side effects, that patient can press the "I have stopped taking this" button to notify the physician that there is an issue and another appointment is needed.
Our API is written in C# and provides access to the SQL backend for the frontend and mobile application use.
Both the API and the Angular Front End pieces have been hosted through Microsoft Azure Platform as a Service in order to create Cloud based applications for easy to scale options giving us the ability to run multiple instances of the API to handle traffic and handle Azure failover to prevent application outages.
So the overall idea and flow of our solution are such:
Physician/Hospital enters the prescription -> Pharmacy automatically receives prescription -> Patient is notified -> Pharmacy fills prescription -> Patient is notified -> Patient receives medication -> Physician is notified -> Patient utilizes app to take adhere to medication requirements -> Physician can see this data
Some challenges faced were inherent in the topic problems themselves. How do we get all of the individual pharmacies to buy into this solution? We decided that it would be easiest to create a service to solve this problem, so there is no real downside to the pharmacy, such as additional data entry, but they can still benefit from patients purchasing more medications.
Credentials for applications: