MEETING REPORT
German hospital pharmacy forges ahead
The theme of the 2022 German Hospital Pharmacists Association ( ADKA ) congress was ‘ Hospital pharmacists – innovative , digital and near to patients ’ and presentations showed how progress has not stood still during the coronavirus pandemic
Christine Clark PhD FRPharmS FCPP ( Hon ) Freelance medical writer
Modernisation of healthcare was a key underlying topic of this year ’ s congress . The German government has enacted legislation to drive forward a number of changes in healthcare including a shift from inpatient to outpatient treatment wherever possible , and extensive digitalisation .
To support these developments up to 4.3 billion Euros have been allocated by the German government in the hospital future fund ( KHZF ). Further funding is expected from the federal states and / or hospital operators .
Digitalisation of medication management is of particular interest because the government has called for the introduction of a closed-loop medication management system by 2023 . This poses a challenge to German hospital systems and pharmacists partly because healthcare is insurance-based , and systems differ from hospital to hospital .
The DKG ( German Hospital Society ) is working closely with the ADKA to support the development and introduction of workable systems . “ ADKA and DKG are partners in medication safety ”, said Dr Gerald Gass , CEO of the DKG , speaking at the congress .
Closed-loop medication management Closed-loop medication management systems seek to establish traceability at every stage of the medication use process from prescribing through to administration , according to Professor Dr Irene Krämer ( Director of Pharmacy , University Hospital , Mainz , Germany ). Digitalisation for medication calls for electronic patient records , electronic prescribing ( with integrated clinical decision support systems ), digitalised drug distribution , barcode- or RFID-supported medication administration and electronic prescriptions for discharge medication . All of this makes considerable demands for interfacing and integration of systems , she noted . Another important element of the digitalisation process is the management of injectable drugs . High-risk injectables should be prepared in the pharmacy either using compounding robots or should be supplied in standardised concentrations . Administration and documentation should make use of smart pump technology and barcoding , she explained .
In order to help hospitals to implement the digitalisation agenda , ‘ must ’ and ‘ can ’ criteria have been drawn up , rather than specifying exactly which systems should be adopted . The ‘ must ’ criteria define the minimum level of digitalisation that is acceptable . The ‘ can ’ criteria describe additional features that institutions might choose to implement .
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Professor Krämer explained how the ‘ must ’ criteria might be implemented in practice . For example , one ‘ must ’ criterion states that there should be a digital record when medication is taken from the storage system . This could be achieved by using electronic medication cupboards on wards . When a dose is taken from the cupboard , an electronic record of the person involved , the medication , and the time of the transaction is automatically made .
Digitalised drug distribution could be achieved by using unit dose systems ( UDDS ) or through the use of single doses issued from electronic medicine cupboards , said Professor Krämer . It may be difficult to issue unit dose injectable medicines and in practice , all systems are hybrids , and this is probably optimal , she added .
Poster highlights A total of 70 posters covered a wide variety of topics .
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