Talking HealthTech: 305 – Overcoming medication safety and operational efficiencies associated with controlled drugs in healthcare. James Gold, Modeus

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Medication errors can create unnecessary work, additional costs, and potentially cause harm or even death for patients. 

Consider this: dispensing the wrong prescription, dosage strength, or dosage form, miscalculating a dose; and failing to identify drug interactions or contraindications — there’s a lot that can go wrong when it comes to administering controlled drugs in a healthcare setting. What systems and technologies are available to assist with this?

Joining Pete in this episode is James Gold from Modeus — one of Australia’s leading suppliers of controlled drug register software. 

In this discussion, you will learn about the myriad of issues associated with traditional controlled drug administration and how they impact healthcare settings; what you can do as an individual to make a difference within healthcare settings that are traditionally slow to make decisions; and the better options out there that can help healthcare professionals manage the burden of controlled drug administration. 

About James Gold

James Gold leads Modeus’ business development and account management teams and manages C-level relationships across customers, vendor partners, and jurisdictional health departments.

James has worked in healthcare software at Modeus for the last nine years. Prior to that, he had various sales and marketing roles. James has a background in sales and marketing, but his passion is in the healthcare and grew up with a solid understanding of the pharmacy industry as his father worked as a pharmacist.

The story of Modeus

The CEO of Modeus, Carl Zufi, founded the company out of an unmet need in the pharmacy industry. Carl ahas experience in the software industry. His father used to bemoan the amount of labour involved in controlled drug management to him because he ran a methadone program. Carl and his father came together to see if Carl could contribute in any way to the creation of a program that resulted in the creation of MethDA, which was launched in 2003. His father was the first one to use it and loved it. It saved him an enormous amount of time. He told his fellow pharmacists about it, and before long he had a small side hobby in addition to his full-time job.

In 2010, Carl created DDBook, a product that is an electronic controlled drug register for schedule 8 drugs as well as methadone programs, all of which are controlled substances that pharmacists are required to record traditionally in registers. Pharmacy professionals were able to switch from redundant paper register systems to an electronic program thanks to DDBook, which was compatible with all of the established pharmacy software. Between 2014 and 2017, they increased their market share from 10% to 70%, which generated a tonne of noise in the business. They have virtually duplicated that business model in a number of healthcare-related industries.

The current state of managing controlled drugs

Controlled drugs are the most powerful drugs behind illegal drugs. Schedule 8 drugs include morphine, methadone, very strong opioids, etc. When administering and transacting these drugs, there is a legal requirement to keep a record or a register of them because there are a lot of issues with these drugs as they’re very powerful. Because they’re very powerful, there can be issues with addiction, misappropriation, fraud, theft, and those sorts of things so governments all around the world have stringent regulations around these drugs. Unlike regular drugs, controlled drugs have that sort of extra level of regulation. In terms of the industry landscape traditionally, these records have been the good old-fashioned paper and pen. 

Even in 2022, many organizations continue to use paper and pens. Therefore, Modeus is setting new ground in Australia. No company developed a product to replace paper for controlled drug regulations. Modeus was the first, and also by far and away the biggest, so they are game changers in community pharmacy since this industry was on paper. Now they are fully on electronic mechanisms for controlled drugs. . Other industries are likewise gradually developing in that direction.

Modeus entered the vet industry in 2015. Now they’re experiencing enormous growth in that industry, really educating the market that there is a better way and also in other industries such as aged care and hospital which have been traditionally slower to adopt those technologies. The wheel is starting to turn in those industries as well.

Common challenges to implementation

Change management is a problem, although it varies by industry. 

In retail pharmacy and in the vet industry, it’s not as much of an issue because generally, the product is very easy to learn and adopt. The team at Modeus just does a remote demo to the pharmacist or veterinary owner and soon after they see it, they think that this is way better than paper and then a trial is organized for them. They can download or access the software via a web browser. Modeus offers training and within a month or two, they’re usually up and running.

However, in aged care and hospitals, due to their structure—a lot more bureaucracy, many levels of management and ownership; with no real ownership in terms of decision-making—it is very decentralized. This can cause a lot of inertia and one has to go through so many different channels within those organizations to get buy-in. Often, the end-users are the first ones Modeus usually reaches out to and they generally love it and they’re big advocates. This is the start of the challenge, especially in hospitals, there are processes such as business cases and change management. Modeus’ hospital product is very complex, unlike the pharmacy and vet products. It goes into a myriad of areas within the organization, not just pharmacy, but also wards, theaters, and training up potentially thousands of staff on the product. They invest heavily in training and implementation and they have a team that manages that process. There’s a lot that goes into it, but once they take that step, they will never go back to paper. 

Managing relationships across different industries

All industries we are embedded in have different systems we have looked to integrate with, and fostering relationships with them can be slow progress. It took a number of years for Modeus to integrate with the main dispense systems in the pharmacy industry and as time went on, we have learned the best approaches to take to reach out to the main players in the other industries we service, like veterinary, aged care and hospital sectors and even the mining sector.

The COVID-19 impact

The pandemic affected the adoption of controlled drug management solutions depending on the industry. The industries primarily affected were aged care and hospital. Of course, as they were dealing with outbreaks, implementing new software was probably the last thing on their minds. Modeus had a lot of good momentum in aged care and had to pull the brakes on it because they didn’t want to bother these aged care groups and individual facilities whilst they were dealing with outbreaks. Likewise, in hospitals, they were also dealing with actual COVID cases and they also had to pull the brakes on those industries. That being said, Modeus got busier in the vet industry as many people were buying pets and they kept open as essential services. So, this industry was very busy for them as well as the pharmacy industry where they are still continuously growing. Overall, it was a two-tiered economy in which some industries were busier than others and some had to slow down.

Champions for change

You have to find champions who are willing to be advocates of controlled drug management solutions. It’s very easy in pharmacy and veterinary as you’re speaking to the decision maker and the owner, and they get it right away. Whereas for hospitals, they love the product and still have conversations but they’re talking five years and still haven’t implemented the system. This isn’t because they don’t want to; rather, it’s because they face their own internal difficulties, like conflicting priorities, COVID outbreaks, and IT. You’ve got to have people that are really driven to make this happen, push it internally, and really reap the benefits. 

There are two things that may also help in promoting this system. One is to build a coalition within the hospital or within the aged care community. It is not just about having a relationship with one person but also fostering relationships with many who have influence within the organization. The second one is to build relationships with directors of pharmacy or clinical teams as they generally have a little bit more influence and power. There are also clinical areas other than pharmacy. Then there’s procurement, IT, and the CFO; essentially the people that have an impact on making decisions. Therefore, building up that coalition and relationships with those types of people will really help.

The Future of Modeus

Modeus recently won a major tender for WA Health, which means that their hospital product is going to be launched in all public hospitals across WA. They are extremely busy in the hospital space and to a lesser extent in aged care but their focus is really continuing to grow in the Australian market.

Moving forward, they also have another goal which is international expansion. They have set up partnerships across numerous countries. One is a partnership with a company called CareFlow Medicines Management which is one of the biggest healthcare software providers to the hospital market in the UK. They will be promoting and selling Modeus’ hospital product across all of the hospitals in the UK. They are also partnering with one of the biggest healthcare companies in Canada for their retail pharmacy market. They’re also about to launch their vet product in the USA where they already have existing customers. It is also highly likely that they will be partnering with one of Europe’s biggest veterinary groups. There is a lot to look forward to in the company. Modeus currently has 25 team members and is on a recruitment drive.

_{Source talkinghealthtech.com}