30 Hrs (2 Hrs/Week)

Scope: This subject deals with the introduction Database, Database Management system,
computer application in clinical studies and use of databases.
Objectives: Upon completion of the course the student shall be able to
1. know the various types of application of computers in pharmacy
2. know the various types of databases
3. know the various applications of databases in pharmacy

Course content: UNIT – I 06 hours

Number system: Binary number system, Decimal number system, Octal number
system, Hexadecimal number systems, conversion decimal to binary, binary to decimal,
octal to binary etc, binary addition, binary subtraction – One’s complement ,Two’s
complement method, binary multiplication, binary division
Concept of Information Systems and Software : Information gathering, requirement
and feasibility analysis, data flow diagrams, process specifications, input/output
design, process life cycle, planning and managing the project

UNIT –II 06 hours

Web technologies:Introduction to HTML, XML,CSS and Programming languages,
introduction to web servers and Server Products
Introduction to databases, MYSQL, MS ACCESS, Pharmacy Drug database

UNIT – III 06 hours

Application of computers in Pharmacy – Drug information storage and retrieval,
Pharmacokinetics, Mathematical model in Drug design, Hospital and Clinical Pharmacy,
Electronic Prescribing and discharge (EP) systems, barcode medicine identification and
automated dispensing of drugs, mobile technology and adherence monitoring
Diagnostic System, Lab-diagnostic System, Patient Monitoring System, Pharma
Information System

UNIT – IV 06 hours
Bioinformatics: Introduction, Objective of Bioinformatics, Bioinformatics
Databases, Concept of Bioinformatics, Impact of Bioinformatics in Vaccine
Discovery

UNIT-V 06 hours
Computers as data analysis in Preclinical development: Chromatographic dada
analysis(CDS), Laboratory Information management System (LIMS) and Text
Information Management System(TIMS)
 NOTES-4

INFORMATION GATHERING

The principal objective of an information system is to provide informational aid to every person
in the organization and hence making him more effective in his working. It is therefore necessary
to monitor the existing information system, identify its deficiencies and updating it to improve
the organizational performance.

These task are taken care by system analysts who first collects the information from the system
users through direct dialogue or through written communication.

The direct dialogue is often referred to as an interview for a written inquiry; the inquirer prepares
a detailed questionnaire and sends it to the information provider, who provides specific replies to
the questions.

These two information search methods interview and questionnaire are used in the following
ways:

1. Interview

It is the most effective method for collection of information for assessing the functioning of
existing system. Both, the system analyst and the system users, must be fully prepared, and have
enough of free time. System analyst must write down the responses of users during the process
of interview.

For getting maximum out of an interview, following factors are important-

A. Selection of persons for interview

All the persons within the system boundaries must be interviewed in an order from top to bottom
from the first system activity toward the last activity. The analyst must enlist all the persons in
the above order and the interviews must be conducted strictly in that order only so that
information integration can be done for system modeling.

B. Interview Methods

The interview of different people has to be conducted differently depending upon their levels and
the information content. Before conducting the interview, the analyst must ensure the status and
role of the person in the information system. Accordingly, an ordered list of questions must be
 NOTES-4

framed for the interview. Each interview must start with simple and convenient questions to
encourage the interviewee.

Questions put during an interview are of two type- closed type-yes/no, suggestive of a reply, and
open type. The sequencing of the question can be-

Open questions and then closed,

Open, closed, and the open again,

Closed and then open,

2. Questionnaire

This method has the advantages of extracting point-to-point information. It saves times of both,
the SA and the system users, as both can work according to their own conveniences.

The questioner technique has the limitation of rigidity and the questions are also prone to
different interpretations by different peoples and hence, extract ambiguous and some time
misleading information.

Problems in information collection for system modeling

Information collection from the users is a tedious and boring task, the common problems in the
information received from various sources are-

1. The information may be ambiguous, incomplete or erroneous

2. The information available is not systematic

3. The information received has some links missing in it,

4. The users of some information are not clear,

5. The System Analyst may not be reaching the real source of information

6. The SA may not be knowing what all is needed

 NOTES-4

Hyper Text Markup Language (HTML)

HTML is the standard markup language for creating Web pages.

 HTML describes the structure of Web pages using markup

 HTML elements are the building blocks of HTML pages
 HTML elements are represented by tags
 HTML tags label pieces of content such as "heading", "paragraph", "table", and so on
 All HTML documents consist of nested HTML elements, below given example contains
four HTML elements:
 Browsers do not display the HTML tags, but use them to render the content of the page

HTML Documents

All HTML documents must start with a document type declaration: <!DOCTYPE html>.
The HTML document itself begins with <html> and ends with </html>.
The visible part of the HTML document is between <body> and </body>.

Example

<!DOCTYPE html>
<html>
<head>
<title>Page Title</title>
</head>
<body>
<h1>My First Heading</h1>
<p>My first paragraph.</p>
</body>
</html>

 The <!DOCTYPE html> declaration defines this document to be HTML5

 The <html> element is the root element of an HTML page
 The <head> element contains meta information about the document
 The <title> element specifies a title for the document
 The <body> element contains the visible page content
 The <h1> element defines a large heading
 NOTES-4

 The <p> element defines a paragraph

HTML Tags

HTML tags are element names surrounded by angle brackets:

<tagname>content goes here...</tagname>

 HTML tags normally come in pairs like <p> and </p>

 The first tag in a pair is the start tag, the second tag is the end tag
 The end tag is written like the start tag, but with a forward slash inserted before the tag
name
 The start tag is also called the opening tag, and the end tag the closing tag.

Web Browsers

The purpose of a web browser (Chrome, IE, Firefox, Safari) is to read HTML documents and
display them.
The browser does not display the HTML tags, but uses them to determine how to display the
document:

HTML Page Structure

Below is a visualization of an HTML page structure:

 NOTES-4

Write HTML Using Notepad

There are four steps below to create your first web page with Notepad:

Step 1: Open Notepad (PC)

Open Start > Programs > Accessories > Notepad

Step 2: Write Some HTML

Step 3: Save the HTML Page

Save the file on your computer. Select File > Save as in the Notepad menu.

Name the file "index.htm" and set the encoding to UTF-8 (which is the preferred encoding for
HTML files).

Step 4: View the HTML Page in Your Browser

Open the saved HTML file in your favorite browser (double clicks on the file, or right-click - and
choose "Open with").

The result will look much like this:

 NOTES-4

HTML Paragraphs

HTML paragraphs are defined with the <p> tag:

Example

<p>This is a paragraph.</p>

<p>This is another paragraph.</p>

HTML Links

HTML links are defined with the <a> tag:

Example

<!DOCTYPE html>

<html>

<body>

<a href="https://www.w3schools.com">This is a link</a>

</body>

</html>

The link's destination is specified in the href attribute.

Attributes are used to provide additional information about HTML elements.

HTML Images

HTML images are defined with the <img> tag.

The source file (src), alternative text (alt), width, and height are provided as attributes:
Example

<!DOCTYPE html>
<html>
<body>
<img src="w3schools.jpg" alt="W3Schools.com" width="104" height="142">
</body>
</html>
 NOTES-4

Introduction to Cascading Style Sheets (CSS)

What is CSS?

 CSS stands for Cascading Style Sheets

 CSS describes how HTML elements are to be displayed on screen, paper, or in other
media
 CSS saves a lot of work. It can control the layout of multiple web pages all at once
 External stylesheets are stored in CSS files

Why Use CSS?

CSS is used to define styles for your web pages, including the design, layout and variations in
display for different devices and screen sizes.

CSS Solved a Big Problem:

HTML was NEVER intended to contain tags for formatting a web page!

HTML was created to describe the content of a web page, like:

<h1>This is a heading</h1>

<p>This is a paragraph.</p>

When tags like <font>, and color attributes were added to the HTML 3.2 specification, it started
a nightmare for web developers. Development of large websites, where fonts and color
information were added to every single page, became a long and expensive process.

To solve this problem, the World Wide Web Consortium (W3C) created CSS.

CSS removed the style formatting from the HTML page!

CSS Saves a Lot of Work!

The style definitions are normally saved in external .css files.

With an external stylesheet file, you can change the look of an entire website by changing just
one file!
 NOTES-4

CSS Syntax:

A CSS rule-set consists of a selector and a declaration block:

The selector points to the HTML element you want to style.

The declaration block contains one or more declarations separated by semicolons.

Each declaration includes a CSS property name and a value, separated by a colon.

A CSS declaration always ends with a semicolon, and declaration blocks are surrounded by curly
braces.

In the following example all <p> elements will be center-aligned, with a red text color:

Example
<!DOCTYPE html>
<html>
<head>
<style>
p { color: red; text-align: center; }
</style>
</head>
<body>
<p>Hello World! </p>
<p> These paragraphs are styled with CSS. </p>
</body>
</html>
 NOTES-4

The id Selector

The id selector uses the id attribute of an HTML element to select a specific element.

The id of an element should be unique within a page, so the id selector is used to select one
unique element!

To select an element with a specific id, write a hash (#) character, followed by the id of the
element.

The style rule below will be applied to the HTML element with id="para1":

Example
<!DOCTYPE html>
<html>
<head>
<style>
#para1 { text-align: center; color: red; }
</style>
</head>
<body>
<p id="para1">Hello World!</p>
<p>This paragraph is not affected by the style.</p>
</body>
</html>

The class Selector

The class selector selects elements with a specific class attribute.

To select elements with a specific class, write a period (.) character, followed by the name of the
class.
 NOTES-4

In the example below, all HTML elements with class="center" will be red and center-aligned:

<!DOCTYPE html>
<html>
<head>
<style>
.center {text-align: center; color: red;}
</style>
</head>
<body>
<h1 class="center">Red and center-aligned heading</h1>
<p class="center">Red and center-aligned paragraph.</p>
</body>
</html>

External Style Sheet

With an external style sheet, you can change the look of an entire website by changing just one
file!

Each page must include a reference to the external style sheet file inside the <link> element. The
<link> element goes inside the <head> section:

Example
<!DOCTYPE html>
<html>
<head>
<link rel="stylesheet" type="text/css" href="mystyle.css">
</head>
<body>
<h1>This is a heading</h1>
<p>This is a paragraph.</p>
</body>
</html>
 NOTES-4

An external style sheet can be written in any text editor. The file should not contain any html
tags. The style sheet file must be saved with a .css extension.

Here is how the "mystyle.css" looks:

body {
background-color: lightblue;
}

h1 {
color: navy;
margin-left: 20px;
}

Note: Do not add a space between the property value and the unit (such as margin-left: 20 px;).
The correct way is: margin-left: 20px
 NOTES-4

Computer Applications in Pharmacy (Unit II)

What is XML?

 XML stands for eXtensible Markup Language

 XML is a markup language much like HTML
 XML was designed to store and transport data
 XML was designed to be self-descriptive
 XML is a W3C Recommendation

Example: This note is a note to Alok from John, stored as XML:

<note>
<to>Alok</to>
<from>John</from>
<heading>Reminder</heading>
<body>Don't forget me this weekend!</body>
</note>

The XML above is quite self-descriptive:

 It has sender information within <to> tag

 It has receiver information within <from> tag
 It has a heading within <heading> tag
 It has a message body. Within <body> tag

All the tags are defined by the author and not predefined like the HTML tags

The Difference between XML and HTML

XML and HTML were designed with different goals:

 XML was designed to carry data - with focus on what data is

 HTML was designed to display data - with focus on how data looks
 XML tags are not predefined like HTML tags are

XML Does Not Use Predefined Tags

The XML language has no predefined tags.

 NOTES-4

The tags in the example above (like <to> and <from>) are not defined in any XML standard.
These tags are "invented" by the author of the XML document.

HTML works with predefined tags like <p>, <h1>, <table>, etc.

With XML, the author must define both the tags and the document structure.

XML Separates Data from Presentation

XML does not carry any information about how to be displayed.

The same XML data can be used in many different presentation scenarios.

Because of this, with XML, there is a full separation between data and presentation.

XML is Often a Complement to HTML

In many HTML applications, XML is used to store or transport data, while HTML is used to
format and display the same data.

XML Separates Data from HTML

When displaying data in HTML, you should not have to edit the HTML file when the data
changes.

With XML, the data can be stored in separate XML files.

With a few lines of JavaScript code, you can read an XML file and update the data content of
any HTML page.
 NOTES-4

Web Servers

A web server is a computer or more formally a software application that runs websites. It's a
computer program that distributes web pages as they are demanded.
The basic objective of the web server is to store, process and deliver web pages to the users. This
intercommunication is done using Hypertext Transfer Protocol (HTTP). These web pages are
mostly static content that includes HTML documents, images, style sheets, test etc.

Apart from HTTP, a web server also supports SMTP (Simple Mail transfer Protocol) and FTP
(File Transfer Protocol) protocol for emailing and for file transfer and storage.
When anyone requests for a website by adding the URL or web address on a web browser’s (like
Chrome or Firefox) address bar (like www.google.com ), the browser sends a request to the
Internet for viewing the corresponding web page for that address.
A Domain Name Server (DNS) converts this URL to an IP Address (For example
192.168.216.345), which in turn points to a Web Server.
The Web Server is requested to present the content website to the user’s browser. All websites
on the Internet have a unique identifier in terms of an IP address. This Internet Protocol address
is used to communicate between different servers across the Internet.
These days, Apache server is the most common web server available in the market. Apache is
open source software that handles almost 70 percent of all websites available today. Most of the
web-based applications use Apache as their default Web Server environment. Another web
server that is generally available is Internet Information Service (IIS). IIS is owned by
Microsoft.
 NOTES-4

Database Management System

A Database Management System (DBMS) is a software application that provide a set of

programms to organize, create, delete, update, and manipulate data in a database.
There are mainly four methods to organize data in a database.
1. Hirarhical
2. Network
3. Relational
4. Object Oriented

In a hirarchical database, the data elements are linked in the form of an inverted tree structure
with the root at the top, and the branceches formed below. There is a parent-child relationship
among the data elements of a hirarchical database. A papernt data element is the one that has one
or more subordinate data elements. The data elements that are below a parent data elements are
its childern data elements.
For exapmple, let us take the example of a hirarchical database of an organizations’s employees.
Eployees are categorized by the department in which they work, and within a department, they
are categorized by their job funciton, such as manager, engineers, technicians, and support staff.
 NOTES-4

A Network database structure is an extension of the hirarchical database strcuture. In this model
also, the data elements of a database are organized in the form of parent-child relationships, and
all the types of relationships among the data elements must be determined when the database is
first designed.
In a network database, however, a child data element can have more then one parent element or
no parent at all. This database permit the extraction of needed information by beginning from
any data element in the database strcuture, instead of starting from the root data element.
For example, network database which maintains the relationships among the courses offered and
the students enrolled for each course in a college. As can be seen from the example, the parent
and child elements can have many-to-many relationships in a network database structure. That is,
each student may be enrolled for several courses, and each course may have a number of
students enrolled for it.
With this database structure, it is possible to easily produce both a course-wise students report (a
report showing all studnets enrolled for each course) and a student-wise courses report (a report
showing all courses taken by each student).
 NOTES-4

In a relational database, the data elements are organzied in the form of multiple tables with rows
and coloumns. Each table of the database is stored as a separate file. Each table coloumn
represent a data field, and each row a data record (all know as tuple).
The data in one table is related to data in another table with a common field.
For exaple, a sample library database is comprised of three tables. The first table contains the
data of library members, the second table contains the data of borrowed books, and the third
table contains the data of books in the library.
Each new member is assigned a membership number and issued a library card with this number
on it. The memebr’s name, address, and membership number are added in member data table.
When a member borrows a book, the membership number of the borrower, the book’s ISBN
number (which serves as a unique identification number for a book), and the due date for
returning the book are added to the second table. The first and second tables are related by the
‘Membership No.’ common field, and the second and third tables are related by the “Book
No.” common field.
Now let us assume that the librarian wants a report of overdue books as of 10-11-2001, and
wants the list to contain the borrower’s details and the book’s details for each overdue book. To
 NOTES-4

produce such a report, the database search routine will first search for the due date field in the
borrowed book data table to surface the three overdues books. The database management system
will then use the ‘Membership No’ filed to cross-reference the book’s details of each overdue
book from the member’s data table, and the ‘Book No.’ field to cross-reference the book’s
details of each overdue book from the book data table. The final report thus produced, would
look something like the one shown in figure.
 NOTES-4

What is SQL?

 SQL stands for Structured Query Language

 SQL lets you access and manipulate databases
 SQL is an ANSI (American National Standards Institute) standard

What Can SQL do?

 SQL can execute queries against a database

 SQL can retrieve data from a database
 SQL can insert records in a database
 SQL can update records in a database
 SQL can delete records from a database
 SQL can create new databases
 SQL can create new tables in a database
 SQL can create stored procedures in a database
 SQL can create views in a database
 SQL can set permissions on tables, procedures, and views

A database most often contains one or more tables. Each table is identified by a name (e.g.
"Customers" or "Orders"). Tables contain records (rows) with data.

For example, a sample database table “Customers” is shown below:

Contact Postal
Customer ID Customer Name Name Address City Code Country
1 Alfreds Futterkiste Maria Anders Obere Str. 57 Berlin 12209 Germany
Ana Trujillo
Emparedados y Avda. de la México
2 helados Ana Trujillo Constitución 2222 D.F. 5021 Mexico
Antonio Moreno Antonio México
3 Taquería Moreno Mataderos 2312 D.F. 5023 Mexico
Thomas WA1
4 Around the Horn Hardy 120 Hanover Sq. London 1DP UK
Christina S-958
5 Berglunds snabbköp Berglund Berguvsvägen 8 Luleå 22 Sweden
Table Customers
 NOTES-4

The following SQL statement selects all the records in the "Customers" table:

Example

SELECT * FROM Customers;

The SQL SELECT Statement

The SELECT statement is used to select data from a database.

The data returned is stored in a result table, called the result-set.

SELECT Syntax

SELECT column1, column2, ...

FROM table_name;

The following SQL statement selects the "Customer Name" and "City" columns from the
"Customers" table:

Example

SELECT Customer Name, City FROM Customers;

SELECT * Example

The following SQL statement selects all the columns from the "Customers" table:

Example

SELECT * FROM Customers;

The SQL WHERE Clause

The WHERE clause is used to filter records.

The WHERE clause is used to extract only those records that fulfill a specified condition.
 NOTES-4

WHERE Syntax

SELECT column1, column2, ...

FROM table_name
WHERE condition;

WHERE Clause Example

The following SQL statement selects all the customers from the country "Mexico", in the
"Customers" table:

Example

SELECT * FROM Customers

WHERE Country='Mexico';
 NOTES-4

Pharmacy Drug Databases:

DrugBank

The DrugBank database is a comprehensive, freely accessible, online database containing

information on drugs and drug targets. As both a bioinformatics and a cheminformatics
resource, DrugBank combines detailed drug (i.e. chemical, pharmacological and pharmaceutical)
data with comprehensive drug target (i.e. sequence, structure, and pathway) information.

DrugBank is widely used by the drug industry, medicinal chemists, pharmacists, physicians,
students and the general public. Its extensive drug and drug-target data has enabled the discovery
and repurposing of a number of existing drugs to treat rare and newly identified illnesses.

The latest release of the database (version 5.0) contains 9591 drug entries including 2037 FDA-
approved small molecule drugs, 241 FDA-approved biotech (protein/peptide) drugs, 96
nutraceuticals and over 6000 experimental drugs. Additionally, 4270 non-redundant protein
(i.e. drug target/enzyme/transporter/carrier) sequences are linked to these drug entries.
 NOTES-4

Comparative Toxicogenomics Database (CTD)

The Comparative Toxicogenomics Database (CTD) is a public website maintained by the

Department of Biological Sciences at North Carolina State University; it is a research tool that
curates scientific data describing relationships between chemicals/drugs, genes/proteins,
diseases, taxa, phenotypes, GO annotations, pathways, and interaction modules.

CTD is a unique resource where biocurators[6][7] read the scientific literature and manually
curate four types of core data:

1. Chemical-gene interactions
2. Chemical-disease associations
3. Gene-disease associations
4. Chemical-phenotype associations
 NOTES-4

HOSPITAL AND CLINICAL PHARMACY

Hospital pharmacy is division of hospital which monitors on the receiving and allotment of drugs
and medicines and professional supplies, stores them and dispenses to inpatient, outpatient and
may have a manufacturing extension to manufacture pharmaceuticals and *parenteral in bulk.
Clinical pharmacy is the branch of Pharmacy where pharmacists provide patient care that
optimizes the use of medication and promotes health, wellness, and disease prevention.

Patient record maintenance is vital job in hospitals but with the help of computers, data can be
maintained easily and also updated time to time. Inventory control i.e. purchasing, receiving,
warehousing and storage, turnover, and reordering can be achieved very well by using
computers.

Computers can play role like:

1. To detect the items which have reached minimum order level?

2. To prepare list of items to be purchased and their quantities.
3. To prepare purchase orders for vendors and to avoid duplication.
4. To detect the infrequently purchased items for possible return or elimination from
pharmacy’s drug supply.
5. To produce periodic summary and purchasing and inventory control statistics.
6. Maintaining patient medical record.
7. Drug information services.
8. Patient monitoring.
Softwares like Microsoft Excel are useful in maintenance of all type of numerical data.
The drug interactions may be screened by using programs like MEDIPHOR (Monitoring and
Evaluating of Drug Interactions by a PHarmacy Oriented Reporting), and PADIS (Pharmacy
Automated Drug Interaction Screening); these systems issues warning when potentially
interacting drugs are prescribed for a patient and thus enhance the standard of a pharmacist’s
clinical services.
 NOTES-4

PHARMACOKINETICS AND MATHMATICAL MODEL IN DRUG DESIGN

Pharmacokinetics (PK) describes how the body affects a specific xenobiotic/chemical after
administration through the mechanisms of Absorption, and Distribution, as well as the
Metabolic changes of the substance in the body (e.g. by metabolic enzymes such as cytochrome
P450* or glucuronosyltransferase enzymes), and the effects and routes of Excretion of the
metabolites of the drug. These four processes: Absorption, Distribution, Metabolism and
Elimination or Excretion are also called ADME.

*Cytochromes P450 (CYPs) are primarily membrane-associated proteins located either in the inner membrane of
mitochondria or in the endoplasmic reticulum of cells. CYPs are the major enzymes involved in drug metabolism,
accounting for about 75% of the total metabolism. Most drugs undergo deactivation by CYPs, either directly or by
facilitated excretion from the body. Also, many substances are bioactivated by CYPs to form their active
compounds.
 NOTES-4

Nearly 40% of drug candidates fail in clinical trials due to poor ADME (absorption, distribution,
metabolism, and excretion) properties. These late-stage failures contribute significantly to the
rapidly escalating cost of new drug development. The ability to detect problematic candidates
early can dramatically reduce the amount of wasted time and resources, and streamline the
overall development process.

Accurate prediction of ADME properties prior to expensive experimental procedures, such as

HTS, can eliminate unnecessary testing on compounds that will ultimately fail; ADME
prediction can also be used to focus lead optimization efforts to enhance the desired properties of
a given compound. Finally, incorporating ADME predictions as a part of the development
process can generate lead compounds that are more likely to exhibit satisfactory ADME
performances during clinical trials.

The increased speed of computers as well as their storage capacity has led to the development of
numerous computer software programs that now allow for the rapid solution of complicated
pharmacokinetic equations and rapid modeling of pharmacokinetic processes i.e. in-silico
pharmacokinetics.

Some software used in. in-silico pharmacokinetics: QikProp, VolSurf, GastroPlus, ALOGPS,
OSIRISPropertyExplorer, SwissADME, Metrabase, PACT-F, TOXNET

Electronic Prescribing (EP) systems

A medical prescription is given by a physician or other qualified health care practitioner

generally that govern the plan of care for an individual patient to purchase a prescription drug
from a pharmacist. In recent times, computer-based medical prescriptions also called Electronic
prescribing or e-prescribing (e-Rx) are being used by the physician.

E-prescribing allows a physician, pharmacist, nurse practitioner, or physician assistant to

electronically transmit a new prescription or renewal authorization to a community or mail-order
pharmacy. It outlines the ability to send error-free, accurate, and understandable prescriptions
electronically from the healthcare provider to the pharmacy. E-prescribing is meant to reduce the
risks associated with traditional prescription script writing. It is also one of the major reasons for
the push for Electronic Medical Records.
 NOTES-4

An E-prescribing system must be capable of performing all of the following functions:

1. Patient identification
2. Generating a complete active medication list, possibly incorporating electronic data
received from an insurance provider
3. Access to patient historical data
4. Prescribe or add new medication and select the pharmacy where the prescription will be
filled.
5. Educational capabilities (e.g., patient education, provider feedback)

Electronic Discharge (ED) systems

Paper based discharge summaries are often illegible, incomplete or received too late for the
information to be considered clinically useful. Electronic discharge summaries can address
known deficiencies and improve the continuity of care, communication and accuracy of data
in discharge summaries. eDischarge solution enables doctors to:

1. Rapidly record all diagnoses, treatments & medications at the point of care.
2. Consultants can review & approve discharge summaries even after the patient has left
the hospital.
3. If the consultant sees any omissions or errors, these can be added or corrected to the
updated summary filed and sent to the patient’s physician instantaneously on
approval.
 NOTES-4

Barcode medicine identification and automated dispensing of drugs

Bar code medication administration (BCMA) is a bar code system to prevent medication errors
in healthcare settings and to improve the quality and safety of medication administration. The
overall goals of BCMA are to improve accuracy, prevent errors, and generate online records of
medication administration.

One type of bar code used on medication packaging

An automated dispensing cabinet (ADC) is a computerized drug storage device or cabinet

designed for hospitals. ADCs allow medications to be stored and dispensed near the point of care
while controlling and tracking drug distribution. They also are called Automated Dispensing
Machines (ADMs).

Automated Dispensing Machine (ADM)

Wrong drug and wrong dose errors are the most common errors associated with ADC use. Look-
alike drug names and drug packages are common variables that lead to selection errors. For
example, morphine and hydromorphone are two different opioid analgesics that frequently get
confused.
 NOTES-4

Mobile technology and Adherence monitoring

Adherence is generally described as the extent to which patients take medications as prescribed
by their health care providers. Adherence to long-term therapy in outpatient setting is required to
reduce the prevalence of chronic diseases such as HIV/AIDS, Diabetes, Tuberculosis and
Malaria.

Healthcare providers are using a variety of mobile technologies to help patients take their
medications and remain on a care plan. The consequences of non-adherence can be costly - and
deadly.

To remind people to pick up or renew their prescriptions, doctors and pharmacies are using
mHealth platforms that send automated, personalized messages to a patient’s e-mail,
smartphone or even a smartwatch (patients can program their own reminders as well). Digital
or smart pillboxes, meanwhile, can keep track of medications, remind a patient to take a
medication and even record and send that data back to caregivers.

Digital or smart pillboxes

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Smart Watches

Patient Monitoring System

Patient monitoring can be rigorously defined as “repeated or continuous observations or

measurements of the patient, his or her physiological function, and the function of life support
equipment, for the purpose of guiding management decisions, including when to make
therapeutic interventions, and assessment of those interventions”

There are at least five categories of patients who need physiological monitoring:

1. Patients with unstable physiological regulatory systems; for example, a patient whose
respiratory system is suppressed by a drug overdose or anesthesia

2. Patients with a suspected life-threatening condition; for example, a patient who has findings
indicating an acute myocardial infarction (heart attack)

3. Patients at high risk of developing a life-threatening condition; for example, patients

immediately after open-heart surgery or a premature infant whose heart and lungs are not fully
developed

4. Patients in a critical physiological state; for example, patients with multiple trauma or septic
shock.

5. Mother and baby during the labor and delivery process.

 NOTES-4

Because of these requirements, ICUs have become widely established in hospitals. Such units
use computers almost universally for the following purposes:

1. To acquire physiological data frequently or continuously, such as blood pressure readings

2. To communicate information from data-producing systems to remote locations (e.g.
laboratory and radiology departments)
3. To store, organize, and report data
4. To integrate and correlate data from multiple sources
5. To provide clinical alerts and advisories based on multiple sources of data
6. To function as a decision-making tool that health professionals may use in planning the
care of critically ill patients
7. To measure the severity of illness for patient classification purposes
8. To analyze the outcomes of ICU care in terms of clinical effectiveness and cost
effectiveness

Pharmacy Management Information System (PMIS)

Pharmacy Management Information System (PMIS) basically deals with the maintenance of
drugs and consumables in the pharmacy unit. The system will ensure availability of sufficient
quantity of drugs and consumable materials for the patient. This will enhance the efficiency of
clinical work; ease the patients’ convenience and process drug prescriptions effectively.

The system will help removing time wasting, saving resources, allow easy access to medicine, as
well as bring on more security on the data compared to manual based system.

Importance of PMIS

1. A good PMIS provides the necessary information to make sound decisions in the
pharmaceutical sector.
2. Effective pharmaceutical management requires policy makers, program managers and
health care providers to monitor information related to patient adherence, drug resistance,
availability of medicines and laboratory supplies,
3. Patient safety, product registration, product quality, financing and program management
etc.