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Definition of triggers and content in support of interaction between healthcare information systems (HIS) and automated dispensing cabinet systems (ADC).

Specifically, the HIS maintains a "floor stock" table that permits it to know whether or not a pharmacy dispense will be required for a new or changed medication order. This table maintains a list of the medications that are "floor stock" (that is, stored in an automated dispensing cabinet) on a particular nursing unit, and a list of the patient rooms on that unit. Using this table, the HIS can determine whether the pharmacy needs to dispense medication in response to a new or changed order based on whether or not that medication is already available in one or more automated dispensing cabinets that service that unit.

The list of medications stored is incremented based on a "load" event (placement of a new medication into the cabinet) or an "unload" event (removal of a medication supply from the cabinet). As a result of such events, the ADC system must notify the HIS that its floor stock table must be updated.

Typically, these interactions also provide information on the current inventory of the medication in the cabinet(s) serving a particular nursing unit, and the location(s) within the cabinet(s) where those medications may be loaded. This information permits electronic Medication Administration Records (eMAR) published by the HIS to inform the nurse where medications are located. Messages from the ADC to the HIS may therefore be generated any time the inventory within a cabinet is incremented (refilled, or loaded) or decremented (dispence from cabinet, unload from cabinet).

These activities are distinct from traditional "dispense" activities in that they are not patient-specific (that is, they represent the intent to store medication in cabinets on patient care areas that will be "dispensed" to individual patients from the cabinets as is needed).

3.b. Project Need

Current HL7 transactional systems do not support this interaction use case. The result is that these interactions are maintained in version 2.x HL7 messages using non-standard segments (Z-segments). The result of this implementation is that health systems that either change out HIS products (host conversions) or ADC systems are required to purchase and implement new interfaces at significant costs in both money and time. Standardizing these interactions would remove some, but not all, of the effort associated with such changes.


6.d. Project Approval Dates

Click here to go to HL7 Project Scope Statement Instructions#Appendix A for more information regarding this section.
Approvals are by simple majority vote of the approving body