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Closed Loop Medication Management System

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What It Is

Th​e Closed Loop Medication Management (CLMM) System is a revolutionary process that integrates automated and intelligent systems to completely close the inpatient medication management and administration loop. 

By digitalising this process, this Smart Health system has significantly enhanced patient safety and improved efficiency of the entire medication management process, from prescription ordering and supply to the administration of the medication.​

 

Background

IHiS rolled out the CLMM system at KK Women's and Children's Hospital (KKH), National University Hospital (NUH) and Tan Tock Seng Hospital (TTSH), Changi General Hospital (CGH), Institute of Mental Health (IMH), Khoo Teck Puat Hospital (KTPH), and Singapore General Hospital (SGH).

With the implementation of CLMM at Ng Teng Fong General Hospital (NTFGH) in FY2015, the programme has been completed for all the hospitals.​

How it Works

 
​NUH, TTSH, IMH ​KKH ​CGH, KTPH ​SGH
Doctors enter patients’ medication orders into Electronic Medical Records system.​ ​ ​ ​
​Clinical Decision Support System prompts doctors with information to avoid drug interactions, allergies and adverse drug events.​ ​ ​
​ Pharmacists verify medication orders, which are then sent automatically to Inpatient Pharmacy Automation System (iPAS).​ ​ ​
iPAS’ robot machines pack and supply the medication into unit dose or patient specific sachets.​ ​ ​ ​
​-​Bulky items not packed by iPAS robot machines are routed to OPAS for packing, achieving higher automation.-​ ​
​The barcoded sachets are kept in intelligent electronic cabinets at the wards.
 
Nurses select the patient names and trigger specific drawers to open and light up, guiding nurses to quickly pick the correct drugs.
​The barcoded sachets are stored in password-protected medication carts and wheeled to the wards.

Medication is stored at the wards, and loaded onto medication carts.

Nurses scan and match the QR barcodes on the patient’s wristband and drug sachets, before serving the medicine. ​ ​

QR-coded sachets of non-ward stock medication are loaded into patient specific drawers on mobile medication carts. Ward stock medication are stored at the ward’s Automated Medication Cabinets (AMCs), and can be queued remotely from the medication carts.

Scanning of the patient’s RFID wrist tag unlocks the assigned drawer. Nurses scan the drugs’ QR-code to ensure serving of the right medicines to the right patient.​ ​

​ ​Nurses scan and match the barcodes on the patient’s wristband and drug sachets, before serving the medicines.

 

 

Benefits

For Healthcare Staff
Automation of processes has led to faster turnaround, saving nurses substantial time previously spent on medication administration. This allows nurses to spend more time on direct patient care.

Medication inventory management has also improved, reducing annual holding costs by 30%.

For Patients
CLMM enables timely pharmacist review of prescriptions and automates checks during the transfer of patients’ essential information to ensure correct medication serving, reducing risks of medication errors and adverse drug events.

Doctors are also alerted to recheck their prescriptions, substantially decreasing cases of drug allergies and improving patient care. 

Additional Information 

The CLMM system achieved several awards:
•HIMSS Elsevier Award 2013, Outstanding ICT Achievement
•CIO Asia Award 2012
•Best PS21 Project 2011, Gold Award
•Singapore Infocomm Technology Federation (SiTF) Award 2011, E-Government

•National Infocomm Award 2010, Winner, Most Innovative Use of Infocomm Technology (Public)

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