Why EMAR? A Case Study

In this guest blog post, Mark Anderson, Chief Client Officer at Eldermark, delves into the importance of Electronic Medication Administration Record (EMAR) technology in senior living settings.

Drawing from a recent Minnesota Department of Health investigation, Mark highlights a critical incident where a resident's medication mismanagement led to severe health consequences. This case underscores the need for EMAR systems, which offer medication supply alerts, accurate documentation, real-time refill requests, and enhanced accountability.

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In Minnesota, the results of assisted living care complaint investigations are public and published weekly. I often review these reports to learn from them. Recently, an investigative report highlighted the value of implementing Electronic Medication Administration Record (EMAR) technology, prompting me to write this blog. Here is a case study showing how EMAR technology can enhance medication management in senior living settings.

A recent Minnesota Department of Health (MDH) investigation found that a resident at an assisted living facility experienced neglect due to not receiving prescribed medications, resulting in a hypertensive crisis (a sudden and severe increase in blood pressure that can lead to life-threatening health problems) and hospitalization. The resident had run out of Olanzapine (a psychotropic medication), and the nurse failed to reorder it. Despite this, the medication technician continued to document administration on a paper record, leading to a 12-day period without the medication.

The investigation revealed that the nurse did send a fax to the pharmacy, but the prescriber did not respond to requests for an updated order. Medication technicians were given incomplete instructions on the paper Medication Administration Record, and care staff signed off on medications without knowing the specifics.

Family intervention led to an updated prescription, but the resident never returned to their previous health status.

This incident demonstrates how EMAR technology can prevent such issues:

• Medication Supply Alerts: EMAR systems alert nurses before medication supplies run out, allowing time for refills.
• Documentation Accuracy: EMAR provides detailed information on medications, dosages, and administration routes, including medication descriptions, images, and med counts, preventing errors.
• Real-Time Refill Requests: EMAR allows electronic refill requests and status updates, avoiding delays.
• Enhanced Accountability: EMAR systems ensure staff know what medications they are administering and accurately document each dose, time stamped with the caregiver identification.

Numerous studies have demonstrated that EMAR technology can significantly reduce medication errors in healthcare settings. Here are some key findings:

1. Reduction in Administration Errors: A study published in the Journal of the American Medical Informatics Association found that EMAR systems reduce medication administration errors by providing timely alerts and reminders to healthcare providers .
2. Improved Documentation Accuracy: Research in the American Journal of Health-System Pharmacy indicated that EMAR improves the accuracy of medication documentation, reducing the likelihood of discrepancies between prescribed and administered medications .
3. Enhanced Communication and Workflow: A study in the Journal of Nursing Administration highlighted that EMAR systems enhance communication between nursing staff and pharmacists, streamline workflows, and improve overall medication management processes .
4. Decreased Omissions and Duplications: According to a study in BMC Health Services Research, EMAR systems significantly decrease the rate of medication omissions and duplications by providing real-time access to patient medication records and alerts .
5. Increased Compliance with Protocols: Research in Clinical Therapeutics found that the implementation of EMAR systems increased compliance with medication administration protocols, leading to fewer errors and improved patient safety .

These studies collectively demonstrate that technology, like the Eldermark NEXT EMAR that integrates directly with the provider’s primary pharmacy software system, plays a critical role in reducing medication errors, enhancing documentation accuracy, improving communication and workflow, and ensuring adherence to medication administration protocols thereby improving care outcomes.

I urge senior living operators to evaluate their medication administration practices and consider the benefits of EMAR technology. Contact Eldermark software experts today to get a personalized walkthrough of what the Eldermark NEXT EMAR can do to improve your team's daily work, and help ensure safe medication management.

Sources:

1. Journal of the American Medical Informatics Association: Study on the impact of EMAR on medication administration errors.
2. American Journal of Health-System Pharmacy: Research on documentation accuracy with EMAR.
3. Journal of Nursing Administration: EMAR’s effect on communication and workflow in nursing.
4. BMC Health Services Research: Study on medication omissions and duplications with EMAR.
5. Clinical Therapeutics: Research on protocol compliance with EMAR implementation.