Transforming medication management – MedChart live at MidCentral

FEATURE -  Industry Innovation Article - Dedalus

• Electronic medication management system MedChart went live at MidCentral in November 2024.

• The new system is integrated with the NZ Universal List of Medicines (NZULM), NZ ePrescription Service (NZePS) and Medicines Data Repository (MDR)

• MidCentral has achieved integration between Dedalus solutions ePharmacy and MedChart, leading to significant efficiencies.

• Early results show the systems are estimated to be saving 16-27 minutes per patient on inpatient medication management and 1.5 minutes per patient on locating medicines.

• The time taken to complete the initial pharmacy review has been reduced by up to 110 mins per patient

• Regular medication reviews have reduced on average by six minutes per patient and discharges by around 33 minutes per patient.
  

Welman says transitioning from paper to electronic medication management has been a major shift for MidCentral’s healthcare professionals, but the response has been overwhelmingly positive. 

"The biggest impact for us has been the integration with ePharmacy," she says. 

“This means pharmacy staff no longer have to wait for a paper order, we can just hit ‘pharmacy requests’, and the medication request lands in our ePharmacy work list,” she explains.

This has reduced the number of keystrokes for pharmacists to dispense medications by around two thirds.

Because medication orders previously involved multiple steps, this created potential for transcription errors or communication delays. 

"It has taken away a lot of the manual processes that used to cause delays. Now, everything is linked and updated in real-time,” she says.

Nursing staff can also simply push a button to send requests to the pharmacy, reducing the need for photocopying and scanning.

Charge nurse at STAR (Services for Treatment, Assessment and Rehabilitation) Palmerston North, Ange Hay says adopting MedChart has supported the timely administration of medications for patients, nurses and prescribers. 

“Since we went live, there have been no reported medication errors: prescriptions are easily readable and there is no more struggling to read doctors’ handwriting,” she says.

“Doctors are able to access MedChart anywhere in the hospital so there is no longer a long wait for medication changes to occur, which contributes to timely care.”

Medication errors are a persistent challenge in healthcare.

Welman says the new system provides decision support during prescribing, alerting clinicians to serious interactions and incorrect dosing.

"One of the immediate benefits we noticed was the automatic flagging of potential drug interactions," says Welman. 

"Before, we had to cross-check manually, but now the system alerts us instantly."

With MedChart there is no ambiguity: the pharmacy gets the prescription exactly as it was entered, without needing to decipher handwriting or double-check verbal orders, she says.

The electronic system gives nurses advice on administering medicines, including handling hazardous drugs, and information on where to find specific drugs, leading to savings of 1.5 minutes per patient on locating medicines.

A MedChart icon on every computer in the organisation also means prescribers can enter a chart from anywhere in the hospital, enabling clinical review to happen anytime, freeing up further clinical resources.

The integration of MedChart with ePharmacy has driven significant efficiency gains across hospital workflows. 

Seamless communication between prescribers and pharmacists has improved medication turnaround times as pharmacists no longer have to call or fax prescriptions separately.

“That time savings alone is huge—it really reduces cognitive load and allows staff to focus more on patient care," Welman says.

Medication reconciliation used to be a hugely time-consuming process, but is now much smoother as pharmacists can see real-time updates on what has been prescribed, dispensed, and administered—all in one system.

She says the time taken to complete the initial pharmacy review is estimated to have been reduced by up to 110 mins per patient, reducing from 45-160 minutes down to just 40-50 mins.

"Before MedChart, we spent a lot of time verifying orders and following up with prescribers for clarifications. Now, we can process things much faster, which ultimately benefits the patients,” says Welman.

Integration with the NZ ePrescription Service (NZePS) means that on admission or pre-admission, the system can pull through a patient’s medication history from the Medicines Data Repository (MDR).

On discharge, it produces an NZePS compliant prescription to be sent to the pharmacy of their choice for collection.

Despite the scale of the change, the implementation of MedChart at MidCentral has been smooth with prescribers, nursing staff and pharmacists embracing the new system, says Welman. 

"Of course, there were initial adjustments, but the training and support made a huge difference and now we cannot imagine going back to the old way of doing things," she says.

"We were worried about resistance, but once people saw how much easier it made their jobs, adoption happened quickly."

MidCentral is now looking to build on its success. 

Welman is looking forward to the quality reporting she will be able to get out of the system on prescribing patterns and patient outcomes.

“It has been transformational for our hospital. When you look at the time saved and how that releases people from administrative tasks and a high cognitive load, it gives staff back the time to care for our patients,” she says.

Te Whatu Ora central region group manager, data and digital, Steve Miller, says the implementation of MedChart in the cloud is part of a broader initiative to regionalise systems within the central North Island. MidCentral, Whanganui, and Wairarapa have already transitioned their Patient Administration System (webPAS) to the cloud.

He explains that adopting common cloud-based systems enables digital staff to concentrate on supporting hospital and specialist teams in delivering high-quality patient care across the country.

"Deploying MedChart in MidCentral has been a significant objective. I am delighted for our staff and community to have reached this milestone,” says Miller. 

“Collaborating across Health NZ to provide a cloud-managed clinical platform assists us in standardising, consolidating, and updating systems nationwide. This accomplishment is a testament to everyone's dedication and hard work.”

Mika Joronen, Dedalus country manager New Zealand, says the successful MedChart implementation at MidCentral demonstrates how digital transformation can deliver meaningful change in medication management by streamlining administrative tasks, as well as  communication between teams for clinical staff, allowing them to focus more on patient care.  

“The integration with ePharmacy, NZULM, NZePS and MDR has helped achieve significant time savings at Te Whatu Ora MidCentral - up to 110 minutes per patient for initial pharmacy reviews and 33 minutes for discharges,” he says. 

“With over 2,000 staff being trained and 85 beds already live, this implementation showcases how electronic medication management can support patient safety and compliance with best practise. We are proud to partner with Health New Zealand Te Whatu Ora MidCentral on this important initiative that is already showing such positive results."

* Intended Use: MedChart is a web-based electronic medication management solution that replaces paper drug charts and supports end-to-end medication management from prescribing, medication monitoring, and dispensing through to administration. The solution incorporates clinical data from the patient’s record and external databases to provide a coordinated approach to patient care. It has been designed for the clinical practices in its target markets of Australia, New Zealand and the UK for public and private hospitals that want to improve the efficiency and quality of medications management.  

If you have any questions re the above feature article, please contact the editor Rebecca McBeth.

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