Customer: MediSystem Pharmacy™ – a Shoppers Drug Mart® Company, pharmacy service provider to long- “MediSystem was the first pharmacy in Canada to start us-ing a DP&P prescription ordering system in a long-term care Challenge: To replace pen, paper and faxing with a faster, more accurate Henry Leung, VP of IT at MediSystem Solution: DIGIORDER, a solution
all these prescriptions had to be sorted
service provider to long-term care facilities
and inserted into resident charts again,
thereby increasing the likelihood of error or
digital pen and paper ordering system that
Because doctors’ rounds in a long-term
scriptions are recorded and filled. The appli-
care facility involve many residents and
Benefits: The pharmacy can reduce
cation, developed by InfoMax Technologies,
an Anoto partner, allows doctors to fill out
handled over a short period of time, there
prescription forms for each resident visited
was often a back log and, consequently, a
in the facility, using Anoto Digital Pen and
delay before all prescriptions were sent off to
Paper technology (DP&P). The result is that
prescriptions are delivered faster and more
This could mean a long wait for residents
accurately, improving the quality of care and
in need of medication, while also increas-
keeping a precise record of all medications
ing the risk of errors in data transmission
prescribed. Full deployment of the applica-
between the long-term care facility and the
tion began in February 2006 and it is now in
use at over 95% of the facilities served by
cies in the prescription records for each
resident. Fax output at the pharmacy could
be blurred, and often pharmacy staff had to
Canada to start using a DP&P prescription
call back the nurses at the long-term care
ordering system in a long-term care environ-
facility for clarification, causing more time on
ment. Seeing how well it works, everyone is
each side. Furthermore, there was no way
interested in it and wants to adopt the same
of guaranteeing that faxes “successfully”
or a similar system. Once again, MediSystem
transmitted were actually received by the
is setting the norm in the industry”, says
Henry Leung, VP of IT at MediSystem.
On the other hand, doctors were accu-stomed to using traditional pen and paper
Background
to write prescriptions, finding it easy to fill
Residents in long-term care facilities are
out forms during their rounds of the wards.
visited regularly by doctors, who assess
Nursing staff were also familiar with the
their condition and adjust their medications
paper forms, which provided a written trace
the InfoMax Digital Pen Platform located at
or prescribe new medications according to
of medications prescribed, to be kept on
need. Until recently, these prescriptions were
Initially, solutions with tablet PCs, mobile
written out by doctors with regular pen and
paper and had to be collected and collated
How the new solution works
However, these options were discarded as
by nurses, sometimes taking hours of work.
The digital pen and paper solution consists
they would definitely require more train-
The nursing staff then faxed these prescrip-
of digital pens and forms with Anoto’s unique
ing and changes in behavior on the part of
tions to the pharmacy manually, which also
pattern, (featuring multiple blanks with
doctors and nursing staff. Additionally, these
free spaces so that they can be used over
other technologies would be more costly to
a period of time), a dedicated InfoMax data
procure, and require more effort to imple-
processing and delivery of the medications
transmission appliance as a docking station
ment, time to deploy, as well as time and
from the pharmacy side. After faxing them,
for the pen, connected via secure Internet to
Partner profile: InfoMax Technologies Corporation, based in
facilities’ business, while new business is
Toronto, Canada, is an Anoto partner. It is the
ment to many locations in a short period of
generated through marketing the DP&P
leading digital writing solution provider in
time. With the simple appliance set up, the
technology to new long-term care facility
Canada with solutions in use by thousands
ongoing support cost is also greatly reduced.
of users on a 24/7 basis, based on the
Studies have shown that accuracy is the best
unique InfoMax data transmission appliance
and technology is the least intrusive with the
Prescriptions arrive earlier in the day, which
and InfoMax Digital Pen Platform. InfoMax
allows the pharmacy to complete its work
has one of the largest installation bases
earlier and consequently reduce its opening
of digital writing technology in Canada. Its
facility, doctors carry a binder containing
roots began in IT consulting, and it is one of
forms with each resident’s profile informa-
the most comprehensive companies in the
tion. These forms are printed on paper with
Key benefits for staff and residents world of information communication and
Anoto’s unique pattern. After seeing each
For care providers, the challenges of adapt-
systems integration. InfoMax is dedicated
resident, the doctor writes down what medi-
to implementing Digital Pen and Paper
cation or treatment is needed on the resident
technology and deploys digital writing
form, using a digital pen. The pen looks and
properly, they can continue to work in the
solutions to principal Canadian businesses in
feels like any regular ink pen, but contains
healthcare and other market sectors.
a tiny infrared camera and processor which
enables it to “read” and digitize pen strokes
the tedious work of compiling and faxing
as they are written on the resident form.
prescriptions to the pharmacy is eliminated,
At the end of the round, the doctor docks
Customer profile:
the digital pen to the dedicated appliance at
prescriptions is also eliminated, and the staff
Founded in the late 1980s, MediSystem
the nursing station. These appliances are
can now review each resident’s prescription
Pharmacy™ began as Queensway Centre
installed at every nursing station in the facil-
Pharmacy, a small retail pharmacy in
ity. The prescription data contained within
Also, the care providers no longer have to
suburban Toronto in Canada. Its founder
the pen is transferred via secure Internet
shifted the company’s focus in the early
to the InfoMax Digital Pen Platform located
the drug record book as order confirmations
1990s to servicing long-term care facili-
at MediSystem’s data centre. The nurse or
are printed automatically. The new system
ties. On August 31, 2004, the company
doctor receives an automatic confirmation
is time-saving and this fact, combined with
was officially listed on the Toronto Stock
that the data has been successfully trans-
better access to information, ultimately leads
Exchange (TSX), trading under the symbol
mitted, along with a confirmation number for
to better resident care. For example, resi-
(MDY). In October 2006, MediSystem was
dents experience fewer delays in receiving
acquired by Shoppers Drug Mart, the biggest
At MediSystem’s data centre, within the
medication, since prescriptions are handled
pharmacy chain operator in Canada. Since then, MediSystem Pharmacy™ operates as a
scriptions are re-routed to the designated
branch office of the pharmacy chain. Since
Implementation so far
long-term care facilities are required to
As of Q1 2009, over 1,100 pens are in use
keep a record of the orders placed with the
at hundreds of locations on a 24/7 basis,
pharmacy, a confirmation is automatically
Anoto Digital Pen and Paper technology
technology gains recognition. MediSystem
An Anoto Digital Pen looks and feels like a
is printing over 100,000 forms with Anoto’s
normal ballpoint pen. However, it contains
care facility, nursing staff can check the
an integrated digital camera, an advanced
delivery against the printed confirmation to
image microprocessor and a Bluetooth®
make sure nothing is missing. The InfoMax
transmitter. Any paper can be used with a
Digital Pen Platform and IT infrastructure at
DP&P applications – including resident
digital pen, if the Anoto dot pattern is added
MediSystem are designed to be highly scal-
admission forms, which have been in use at
to the layout before printing the paper. The
able and able to handle the ever increasing
long-term care facilities since July 2008. This
Anoto dot pattern consists of numerous
is another cost-effective tool, since the same
black dots that can be read by the digital pen, but are almost invisible to the naked eye. The Key benefits for MediSystem
being used. Furthermore, a special “Tamiflu
pen reads the pattern and registers what and
MediSystem has seen a significant increase
dosage form” (for administering anti-influ-
in productivity as a result of this applica-
enza drugs to residents) was implemented
tion. It saves the nurses’ time and allows
quicker resolution of questions and queries. Furthermore, DP&P gives MediSystem a
Anoto Group AB is the company behind and world leading in the unique technology for digital pen and paper, which enables
fast and reliable conversion of handwritten text into digital format. Anoto operates through a global partner network that focuses on user-friendly forms solutions for efficient capture, transmission and storage of data within different business
segments, e.g. healthcare, bank and finance, transport and logistics and education. The Anoto Group has around 80 employ-
www.anoto.com
ees, offices in Lund (head office), Boston and Tokyo.
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Constraints in Seeking Treatment at Public Health Units for Children with Severe Malaria: a District Case Study in Uganda. Kivumbi George .W, Mortensen Erik.L, Whyte Susan.R, Bybjerg Ib.C. Draft_16-May-02 Introduction Malaria is still a major cause of death and severe illness among children in many parts of tropical Africa, Uganda inclusive. It is responsible for betw