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13 June 2019

Senior Clinical Pharmacist Nicole Harris works in the Critical Care Unit of Sydney’s Royal North Shore Hospital. She is a member of the Society of Hospital Pharmacist Critical Care Practice Group and the Medication Safety Practice Group and holds a Board of Pharmacy Specialities Certification in Geriatrics.

We spoke to Nicole about how My Health Record can help pharmacists. 

What does your work as a clinical pharmacist involve?

My job is to ensure patients in intensive care receive the best possible pharmaceutical care. This means on a daily basis taking medication history, medication reconciliation, developing pharmaceutical plans, therapeutic drug monitoring and adjustments pending the patient’s current condition and prior health issues.

How does My Health Record help you in your daily practice?

Patients often arrive at the hospital after hours and on weekends when community healthcare providers are not available. Obtaining a pharmaceutical history in any hospital environment can be challenging, but particularly in intensive care when patients may be unable to provide information and family members do not always know the history.

My Health Record serves as a resource for healthcare professionals to see clinical information about their patient, especially medication and allergy history, which otherwise may not be available. Having this available to me on the wards 24 hours a day, 7 days a week, allows me to do my job more efficiently and effectively enabling my patient to have the best chance of a successful health outcome.

The most useful information in the system for my work is the prescription and dispense information, including dates of changes in medications, doses and strengths, along with the listing of other healthcare providers who I can quickly contact to clarify details. The other added benefit is that it makes the process of information sharing with other healthcare professionals more efficient, especially discussing what you can both see in it.

Being able to quickly view a patient’s past medical history, medications, and blood test results helps create an accurate medication history and a more tailored pharmaceutical plan. While this information is not always offered to pharmacists, it is often relevant to medication management.

My Health Record also enables pharmacists to empower patients to manage their own health and improve their health literacy – placing them at the centre of their care.

How does My Health Record help patients?

Medications can be prescribed more accurately and quickly so patients don’t miss doses of essential medications. The system also shows me information about a patient’s hospital admission, and with many emergency department admissions caused by drug-related problems, the quicker and more accurately we can gather and use medication information, the more tailored care we can provide.

I had an extremely unwell septic ICU patient whose family informed me they recently had a course of antibiotics and suffered an adverse drug reaction, but they didn’t remember the medication name or when the patient had taken it. The patient’s community pharmacy and GP were unavailable and the patient no longer had the antibiotics. Using My Health Record, I was able to quickly check which antibiotic had been dispensed, so that I could prescribe an appropriate antibiotic for the sepsis right away, without the risk of another adverse drug reaction.

What advice would you offer your peers about using My Health Record for the benefit of patients?

My colleagues in hospital pharmacy occasionally comment that My Health Record may not contain all a patient’s medical information. While they are correct, it does provide us insight into why a medication was prescribed, identifies information to explore with the patient or offers crucial information at a time when no other information is available. It is also a good place to start to confirm medication information.

The best piece of advice I can offer is just start using it! In my workplace it’s well integrated into our electronic medication management system and is simple and quick to check.

Pharmacists will soon benefit from use of the Pharmacist Shared Medicines List, coming in the next system update. This will be a key document for pharmacists to use as a tool for patient engagement regarding medication management, with the potential to have immediate positive impact for patients and their safety.

My Health Record is a significant resource for all pharmacists and, as more clinical documents are introduced, it will become even more useful in improving pharmacovigilance and patient safety.

Nicole Harris is a Senior Clinical Pharmacist who has spent her career working in hospitals in across Australia and the United Kingdom. Nicole has experience working in a number of clinical areas, specialising in Critical Care and Nutrition. She is a member of the Society of Hospital Pharmacist Critical Care Practice Group and the Medication Safety Practice Group. Nicole has a special interest in Electronic Clinical Information Systems and has worked on multiple projects involving the customisation, quality assurance and implementation of these systems in Australian and United Kingdom hospitals. Nicole Harris is also a clinical reference lead for the Australian Digital Health Agency.