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Professor Ellen Balka implements new software she and her team designed, to reduce preventable adverse drug events
Dr. Ellen Balka, professor in SFU’s School of Communication, and director of the School’s Assessment of Technology in Context Design Lab (ATIC Lab), and her colleague Dr. Corinne Hohl, Associate Professor in UBC’s Department of Emergency Medicine and Vancouver Coastal Health emergency physician, are currently working on a Canadian Institutes of Health Research (CIHR) funded project to reduce preventable adverse drug events (ADEs) in British Columbia
What is an ADE?
ADEs are the harmful and unintended consequences of medication. They are a leading cause of unplanned hospital admissions and contribute to almost 2 million emergency department visits in Canada annually.
Some cases of ADEs happen because of unknown and unexpected reactions to one or more medications. However, research has demonstrated that a significant proportion of ADEs may be repeat events which happen as the result of unintentional re-prescription and re-dispensing of drugs that previously caused harm to a patient. The ActionADE project is aimed at preventing this type of preventable ADE.
ADEs are seldom documented in medical records, and are not communicated electronically either between care providers or across healthcare sectors. Most of the communication about ADEs happens through paper, fax, or phone, and as a result, easily falls through the cracks, increasing the chances of repeat ADEs.
To address this issue, Dr. Balka and Dr. Corinne Hohl, along with their interdisciplinary team, used ethnographic research and participatory design methods to design ActionADE. The software has now been built, and they are now implementing and evaluating the application, called “ActionADE.” One goal is to bridge the information gap related to ADEs, and integrate ADE documentation and reporting into clinical practice. Balka noted that “ActionADE is running as a pilot at the moment as a stand alone application. However, we have been working very closely with the Ministry of Health so that we will be able to integrate ActionADE with PharmaNet, the province’s network that links B.C. pharmacies to a central data system, which is accessed every time a community pharmacy in B.C. dispenses a medication. Getting data into PharmaNet will allow a real-time and systematic communication between different care providers, including pharmacists, emergency physicians and other physicians across different locations.” The electronic system will get up to date information about ADEs to care providers and pharmacies. Since pharmacies are where drugs are dispensed, getting ADE information to where drugs are dispensed will reduce the possibility that a drug a patient has had an ADE with will be re-dispensed to that patient.
Current Project Status
The ActionADE team is currently testing and evaluating the software at Vancouver General Hospital. The project design phase was funded through the Canadian Institute of Health Research’s (CIHR) Partnership in Health System Improvement program. The pilot implementation phase has been funded through CIHR’s eHealth Innovations Improvement program, with over $1.2 million in funding from CIHR, the Michael Smith Foundation for Health Research, and the BC College of Pharmacists as well as in-kind contributions. The team is now preparing their application for the third and final phase of CIHR’s Rewarding Success competition. Balka commented “we learned in May we had made it through the 2nd phase of CIHR’s Rewarding Success program. We received some funding to prepare our final submission for that funding opportunity, so we have had an incredibly busy summer working closely with the Ministry of Health to plan a provincial roll-out of ActionADE, which will include PharmaNet integration.
Balka, Professor at Simon Fraser University, is the principal investigator and co-investigator of numerous projects which have addressed topics such as governance of health system technology and patient safety, development of health indicators, handovers in patient care, telehealth, computerization of triage functions in emergency departments, and the design and development of adverse drug event reporting systems. She has received funding from CIHR, SSHRC, Health Canada, the Michael Smith Foundation for Health Research, and Genome BC.