How to Choose an eMAR system. Part 2 Further Considerations
The first article in this series described the main considerations for choosing eMAR systems and the objectives of achieving safety, increased accountability and efficiencies through stock control. The article introduced further considerations listed below and which are discussed in more detail here.
• How easy is it to implement?
• What hardware is required?
• What happens if the technology goes down?
• Will the medicine rounds take longer?
• Will there be integration with other technologies?
• Will inspectors like it?
• Is the data secure?
• Can I believe the claims of the benefits?
• Who is the company providing it?
• What is the cost?
What does the implementation and training process look like?
Introducing any change needs leadership, planning and resources. Any change affecting medicines management in care homes also needs to take in to account training, medicines policies, coordination of supply of medicines and support during the first few weeks. The more user friendly and intuitive the product, the easier the training and staff acceptance. The more detailed the implementation plan, the greater the chance of success. The more resources and support available, the less time the care home manager needs to provide these.
ATLAS eMAR has an established implementation plan that helps you understand and go through the process at your own pace. There are e-learning modules as well as the option of face to face training. There are a wealth resources available that will make you completely self-sufficient and post implementation there are scheduled support sessions. Should you require additional support this is available in the form of an account manager.
What is the hardware that is required and is it fit for purpose?
The hardware used in care homes for medicines management has to be robust as it is used so many times a day, every day. The hardware will be dropped, have liquids poured on it and will get dirty. Whatever the hardware, it must convenient for the carers and nurses who use it.
ATLAS uses hand-held android tablet devices with built in barcode scanners. They are robust, shock proof and have antimicrobial coating and can easily be wiped down. Most importantly they can be used with one hand.
What if the technology goes down?
Technology enables people but when it goes down, we are at a loss. For a critical process such as medicines administration you will need to know what disaster recovery processes are in place in the rare event that the internet goes down, or if there is a power cut or if the hardware is damaged that it can no longer be used. How quickly will the eMAR company respond and put things right?
For administration of medicines, ATLAS eMAR is designed so that it is not reliant on the internet and the devices are battery operated which can be replaced easily with a spare fully charged battery. The hand-held devices that are used are very robust but in the event of damage to the devices, care homes have the option of having a back-up device. If a back-up device was not available at the care home, there is always the option of printing paper MAR charts from ATLAS Central, the web portal. Damaged devices are swapped out with working devices the next day, so that care homes can continue to administer medicines safely.
Will the medicines administration process take longer?
The medicines administration process with any eMAR should not take longer or be any shorter, because the greatest proportion of time in the process is actually spent with the resident administering and observing that have taken the medicines. Independent evaluation of ATLAS eMAR has shown that there is no difference in the time for administration but there is an average of 65 staff hours saved per month on the whole medicine management process.
Can the eMAR integrate in to care planning system?
There are multiple technologies in the care sector for example eMARs, electronic care planning and fall monitoring applications. The better the integration between the systems, the easier the operations and the sharing of data relating to different aspects of care. In an ideal world, care home operators would be able to choose the best technology for them for each aspect of care and have the ability to have data from all the systems in one place. Currently the eMARs on the market do not integrate with all care planning systems. Some have no integration at all, whilst others only have integration with one care planning system.
ATLAS eMAR has an open Application Programming Interface (API) which specifies how other technologies could integrate and share data. This is unique in the market and the only barrier to integration would be the political will of the companies involved.
Will it help with inspections and contribute to better ratings?
The five rating categories for care homes relate to safe; effective; caring; responsive to people's needs; and well-led. We have already made the case for safety in Part 1 of this article , the more checks in place by the system, the safer the care at the home. Effective care could be evidenced by ensuring that medicines do not run out and non-administration of medicines are monitored and acted up on. Caring and responsive to people’s need could relate to how the eMAR ensures that resident preferences are taken in to account and well led could relate to the information provided by the system for the managers to monitor the status of the medicine processes in the care home.
ATLAS eMAR has the highest level of safety checks and has been proven to eradicate 21 out of 23 error types as compared to manual systems. There are several alerts that ensure that medicines are always accounted for leading to effective care. Resident’s needs, preferences and individualised care are recorded and prompted by the system. Managers can evidence that the care home is well led through the ATLAS Scorecards which have performance monitoring dashboards.
The ATLAS scorecards that enable the monitoring, prediction and improvement in care represents an innovative use of technology which is a key requirement to achieve an “Outstanding” rating.
What about Information Security and GDPR?
Data breaches could lead to 4% fines of the overall turnover of a company, therefore, the information security infrastructure and mitigation of data breaches is a very important consideration when choosing an eMAR.
Invatech Health have achieved an international standard in Information Security called ISO 27001. This means that you can rest assured that ATLAS eMAR is very secure and the processes adopted for data protection are to the highest standards that can be achieved. There are additional articles on Data Security and Information Governance for you to review here.
How do I check the claims of the benefits of the eMAR?
The system supplier’s sales team will all believe that their system is the best and that the eMAR is a magic wand that will solve all your medicines related issues. The best way to find out is for you to independently speak to end users of the system and visit to see it in operation as well doing your own desk-top research. The change of your medicine management system which is a critical part of the care you provide deserves this level of due diligence.
ATLAS eMAR is used nationally and there will inevitably be a care home in your area that is using the system who would be happy to show you how the system works in their home. Register your interest in visiting a care home that uses ATLAS eMAR here.
Who is the company behind the eMAR?
The due diligence of eMAR systems should extend to the parent company to see how long they have been established, their expertise and experience and motivations. The company will be your partner in not only providing the technology but the tools to deliver and monitor care. Information on companies is freely available to the public on sites such as Companies House. This is no different for Invatech Health. You can find out more about the team behind ATLAS eMAR here.
What are the costs and contractual models?
Traditionally care homes have not paid for their medicines management as pharmacies provided systems and equipment free of charge in return for the repeated prescription business. When eMARs were introduced, pharmacies offered these to the care home market at free or substantially reduced costs, with the provision that the care home committed to staying with the pharmacy for 3-4 years. Although on paper zero or reduced costs may seem attractive, this model with a 3-4-year tie in has serious implications:
• The eMAR on offer will be the choice of the pharmacy rather than the choice of the care home
• If the pharmacy service was poor, the care home could not change pharmacies easily because of the terms of the contract and if they did, they would also have to change eMAR systems
• In the event of difficulties with the technology or the management of the data on the eMAR or prescription issues, there is often confusion as to where responsibilities lie. Does the care home call the pharmacy, or the eMAR system supplier?
In terms of costs, most eMAR systems will charge a license fee for the software, there will be a charge for the hardware required and there will be a charge for the implementation and training.
ATLAS eMAR has a contractual model directly with the care home, rather than with the pharmacy. This model means that it is the care home’s choice to have ATLAS eMAR because they believe it is the best for them and if the pharmacy provides a poor service, then the care home is not beholden to the pharmacy and can change pharmacy supplier. Also, lines of responsibilities are clear, ATLAS service team is responsible for anything to do with the technology and the pharmacy is responsible for the safe supply of medicines. There are no lengthy contracts and penalties for leaving the system. There are software license fees, a choice of rental or purchase for the hardware and no charge for the standard implementation and training but with a choice of having more support and face to face training.
Changing your medicines management system is a very important decision and one that should be considered carefully. Electronic medicines administration systems can offer advantages but not all eMAR systems are the same. In these two articles we have outlined the important considerations and questions to be answered when you are reviewing all of the different eMAR systems on the market.