Case
One of the world’s most acute public health problems is the misuse and overuse of antimicrobials, or drugs, as it contributes to antibiotic resistance and poor infection prevention and control, badly impacting the health of patients who are not even exposed to them. In order to address this concern, hospitals can implement an effective guideline and workflow management platform. The guidelines created by the platform can be used for Antimicrobial Stewardship (AMS), one of the strategic objectives of the WHO global action plan on antimicrobial resistance. This rational and systematic approach has become a mandatory program a healthcare institution should implement for their accreditation. Our client, one of Australia’s leading public hospitals, wanted to take a stand against antimicrobial resistance and guide the responsible people (such as junior doctors, nurses, or pharmacists) to find the most appropriate recommendations on drugs or combinations of multiple drugs – based on the patient’s health record and physical findings in a hospital. They reached out to our team at TA to develop an administrative tool – with the help of Universal Indication List (UIL) – and build effective and proper guidelines/workflows in their system.
Challenge
AMS has been a hospital accreditation standard since 2013. Every Australian healthcare facility is expected to get accredited with AMS only if the institution uses an administrative tool to build guidelines and workflows which in turn will help in monitoring and improving the use of antimicrobials. Generally, many healthcare institutions keep an excel listing for guideline management in their desktop systems which is not a long-run solution.
Our client wanted to build a web-based, administrative tool that can be inherited to an efficient guideline and workflow management platform to improve transparency and overall work culture in a practice. Developed using the latest technologies, they wanted an easy management licensed tool that can create guidelines and import existing excel data.
Apart from these challenges, there were a few more requirements the client wanted in their workflow management system which include:
- Appropriate assessments in forming new guidelines and workflows
- Track the use of medicines and collect data regarding the severity of medicines
- Reconciling multiple data sources into proper and meaningful guidelines
Solution
By developing a dynamic administrative tool for guidelines management and workflow creation, we overcome the challenges. From UIL (a centralized system tool), a condition is built with regard to certain criteria such as age, sex, health information, and so on. According to a condition, an appropriate recommendation is built, which is a workflow. The tool can create multiple workflows from an indication and a group of workflows forms a guideline. This guideline is then followed by the hospital or a network of the particular hospital.
This workflow management software mainly covers:
- AntiMicrobial Stewardship: A concept for promoting the rational use of antimicrobial drugs.
- Guidelines: A guideline consists of many workflows to guide the end-users to find the most appropriate recommendations (recommended drug or combinations of multiple drugs) based on the patient’s health record and physical findings in a hospital.
- Workflow: A workflow consists of recommended drugs or combinations of multiple drugs which will be derived based on certain defined conditions for an indication. There could be any number of preferred recommendations and alternate recommendations in a workflow for an indication, the order will be defined by the sequence in which the recommendations are configured on the workflow.
Modules
- User Management
- Guideline Management
Users
- Super Admin
- Can add, edit and remove guidelines
- Can view all guidelines
- Associate new guidelines
- List all users
- Guideline Author
- Owner of a particular guideline
- Can only view, edit and remove their assigned guideline
- Can allot a guideline writer
- Guideline Writer
- Assigned by guideline author
- Create multiple workflows for the associated guidelines
Key Features
- Have a global indication list
- Guideline Managers can create guidelines and publish them to users
- Multiple Guideline Managers can work on the same guideline
- Custom parameters are created as per requirements of the domain
- Can be reviewed in tabular and tree structure
- Can work as a standalone application as well as a plug-into for other systems
- Can preview Guideline
- Flag high-risk indications
Impact
The world urgently needs to change the way it prescribes and uses antibiotics because antibiotic resistance is rising to dangerously high levels in all parts of the world. With the development of this guideline and workflow management software, we can take a stand against antibiotic resistance. The tool benefited our client to improve their clinical outcomes and minimize harm by improving antibiotic prescribing and providing a guideline to find the appropriate drug for a particular disease for a person. Moreover, migration is easier with this tool, that is when it comes to moving an entire system to another, importing guidelines from the existing system to another network seems a bit tedious task.
Other benefits of this tool include:
- Readymade workflows available
- Create new workflows
- Reports are available (which show who used it, how many users used and so on)
- Can import guidelines from an existing system