Excellence in Technology St John WA Electronic Drug Register (EDR) system & Integration with Electronic Patient Care Record (ePCR)

St John WA

Team: Rebecca Minchin, Rudi Brits, Deb Barbas, Curtis Naylor, Reilly Ettridge, John Dwyer, Avinav Duggal

St John WA (SJWA) has introduced a centralised and integrated electronic drug register (EDR) system across Western Australia to track and record aspects of storage, handling, administration and dispensing of all Schedule 8, specified Schedule 4, and Schedule 5(a) drugs. Following an independent WA healthcare review of medication practices, which was prompted by a major inquiry in Victoria into drug misuse and corrupt conduct among paramedics, SJWA investigated a recommendation to move to an EDR in February 2021. Formal commencement of the project began in January 2022 as the selected vendor system ‘StockInsite’ required regulatory approval from the WA Department of Health (DOH) Chief Pharmacist to proceed with development and implementation of an EDR.

An electronic register provides a state-wide closed loop system for tracking of all high-risk medication transactions associated with SJWA poisons permits, such as fentanyl, to strengthen compliance with the Medicines and Poisons Act 2014 and the Medicines and Poisons Regulations 2016. An EDR system replaces current paper-based register methods designed for in-hospital settings.

The system provides robust chain of custody from the distribution warehouse to every SJWA service location, as well as recording patient administration events, returns and disposal/destruction of medications. It will be used across 235 metropolitan and regional ambulance locations with 315 medications storage facilities, 769 medications pouches and about 3900 personnel. The system will monitor and track medications and provide overarching visibility of all frontline areas delivering pre-hospital care across the state, while directly relaying with the regulatory body for greater transparency.

At the point of care, record of medication administration in the existing Electronic Patient Care Record (ePCR) has been integrated with this new EDR so records and stock levels are adjusted and recorded instantly. Frontline ambulance officers, who are often time poor, have directly benefitted from improved workflow, efficiency, accuracy in maintaining records, compliance, medication safety and improved cycle times. These collective benefits will enhance patient safety and deliver operational capacity back for timelier community response.

Innovative design and integration work by SJWA developers underpins the success of this EDR system. Incorporating ePCR - which has internal validation processes, seamless external database integrations, and embedded risk controlsenables a higher degree of accuracy in documenting administration practices in patient care, transparent handling transactions, responsible chain of custody and practitioner protections.