AutoPharmacist: Automated Medication Monitoring System in Primary Care

** 背景 ** 每年超过 **40%的英国人口服用7.7亿定期药物 ** 来管理和预防疾病。他们的全科医生（GP）有确保他们服用正确药物的艰巨任务，** 15%的人口定期服用5种以上药物，25%的人患有多种长期疾病。问题 ** 在过度紧张的卫生系统中，药物可能会...\*过度使用 **：在不必要的情况下，由于副作用，相互作用或无效性，可能有害的药物 ** 应该停止 *目前的做法 ** 医生/药剂师预计. 1.浏览大量的医疗数据，信息“隐藏”在自由文本注释中2.从患者那里收集额外的信息3.保持对每种药物和疾病不断变化的临床指南的最新了解4.识别潜在的副作用和禁忌症5.当治疗不起作用时升级治疗 ** 需要 ** 对所有患者进行定期审查，将现有的，明确的，指导方针将通过 ** 持续的、临床的、针对每个患者的个性化决策 ** 来识别这些错误。改善护理的 ** 潜在好处 ** 是巨大的，估计每年为英国NHS** 带来 ** 25亿英镑。NHS缺乏安全地做到这一点的能力 **，原因是：\* COVID-19加剧了严重的人员短缺\* 要求为每个人重复整个过程，针对健康数据的每次变化，** 解决方案 ** 这款 **_“自动药师”_** 将持续、自动地提取和合理化多个数据源，包括现有的患者EHR记录，对照最新的临床指南，组织自动化的患者问卷调查，标记潜在的不良副作用，并在需要时进行进一步测试。该解决方案是一个 ** 机会，可以有效地提供人口健康 **，同时减少与药物相关的伤害。

**BACKGROUND**Every year over **40% of the UK population take 770 million regular medications** to manage and prevent disease. Their General Practitioner (GP) has the vast task of ensuring they are on the right medications, **with 15% of the population taking more than 5 medications regularly, and 25% having multiple long-term conditions.****PROBLEM**In an over-stretched health system, medications can be...\***Overused**: where unnecessary, potentially harmful medicines **should be** **stopped** because of side effects, interactions or ineffectiveness\***Underused**: where vital, disease-preventing medicines **should be** **started**Both have health consequences and cost implications for the NHS that are entirely avoidable.**CURRENT PRACTICE**Doctors/Pharmacists are expected to ...1. look through large volumes of medical data, with information 'hidden' in the free-text notes2.Collect additional information from patients3.Maintain up-to-date knowledge of ever-changing clinical guidelines for each medicine and disease4.Identify potential side effects and contra-indications5.Escalate therapy when the treatment is not working**NEED**Regular reviews for all patients, putting into practice already existing, clear, guidelines would identify these errors with **continuous, clinical, decisions individualised to each patient**.The **potential benefits of improved care** are enormous, an estimated **£2.5 billion per year to the NHS** across the UK.The **NHS lacks capacity** to do this safely due to:\*Critical staffing shortages exacerbated by COVID-19\*Requirements to repeat the whole process for each person, for every change in health data, regularly throughout the year to capture any safety issues quickly**SOLUTION**This **_"Auto-Pharmacist"_** will continuously, automatically extract and rationalise multiple data sources including existing patient EHR records against up-to-date clinical guidelines, organising automated patient questionnaires, flag potential adverse side effects and further testing where required. This solution is an **opportunity to deliver population health delivered efficiently and effectively** whilst reducing medication-related harms.