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ACHIEVING SERIALIZED PRODUCT TRACEABILITY
FOR QUALITY & SAFETY
Facing Compliance Requirements in the Pharmaceutical Industry
and Personal Liability of the Management

Joachim Misdorf
CEO DataSquare
Hamburg, Germany
Company




                         Deutsche Blister Union
                            (German Blister Union)




ACE 2011 INTERNATIONAL                               Slide 2
Medication Supply


Problem:
        In 2009 we had 15 million hospital patients
         and 25 million in old people’s retirement &
         nursing homes worldwide (source: wikipedia)
        Most of these patients need medication every
         day
Current solution:
        Thousands of nurses put pills into small
         pillboxes by hand every morning
Consequence:
        Procedure is very expensive
        High Error Rate: Patients become ill or even die due to medication or dosage
         errors




ACE 2011 INTERNATIONAL                                                              Slide 3
Existing Process of Medication Supply



                                                               Patient
                  Pharmacy



Prescriptions
                      Medication in                            Patient
                      transport packaging




                                                               Patient



                                    Medication
                                    lists
                                                 Nursing
    Doctor                                                     Patient
                                                  staff


                                                 Medication
                          Hospital,              distributed
                         Retirement &
                                                 by hand!!!    Patient
                        Nursing Home,
                         Care Home


   ACE 2011 INTERNATIONAL                                         Slide 4
Legal Liability


The risk for the CEO and the entire management is:


                                                   Up to

                          lifelong prison terms (US = lifelong / Europe = 10 years)
                                                    plus

                             full personal financial liability (worldwide)
                         for failure to follow the regulations for medication supply


 US Food and Drug Administration (FDA)
 European Medicines Agency (EMA)
 Plus local laws




ACE 2011 INTERNATIONAL                                                                 Slide 5
What Does „Blistering“ Mean?




 Solid, oral medication are provided in a one-week dispenser
 Patient-individual medication supply
        Name
        Date & time
        Kind of drug

ACE 2011 INTERNATIONAL                                          Slide 6
Performance Characteristics




 Capacity per site:                   Minimum 3,000 patients/week
 Total capacity of the DBU network: Approx. 60,000 patients/week (Expansion stage 1)
 Quality Assurance:                   Use of video scanners (each blister pack is
                                       photographed, analyzed and archived)
 Drug safety:                         Patient information leaflet and tablet photo
                                       service
 Training:                            Comprehensive training courses for nursing
                                       staff, patients and their relatives



ACE 2011 INTERNATIONAL                                                                  Slide 7
Serialized Unit Packaging Information



Name & date of birth
of the patient
                                        Hospital ward
                                        Date & time of taking
Dosage & name of
the drug
                                        Kind of drug




                                        Product Code for
                                        Aras Innovator



ACE 2011 INTERNATIONAL                                  Slide 8
Deutsche Blister Union


 Service provider of dose-dispensed
  medicine
 Germany-wide merger of blister
  pharmacies, regionally operating blister
  centers and industrial companies
 Offers service on all aspects of the
  mechanical blistering of drugs for the
  individual patient
 Founded in 2008
 32 blister centers all over Germany
  in 2011
 Market activities in the US since 2011




ACE 2011 INTERNATIONAL                       Slide 9
Old Verification Process in Blister Pack
Production

 Documentation of the production process with production protocols
        Distribution to “qualified persons“ (QP) throughout Germany
        Protocols verified by QPs
        QPs sign the protocols by hand to signify approval
        Archived for over 10 years or for life / amount of paper increasing substantially


                                                                              QP             QP
                                          Protocols sent for
                                          verification
                                                                                        QP             QP

                         Production                Protocols returned after
                                                   verification
                                                                                   QP             QP
                           Approved protocols archived
            Archive
                                                               Takes a lot of time and
                                                               very inflexible!

ACE 2011 INTERNATIONAL                                                                                      Slide 10
New Process for Medication Supply



                                                                                  Patient
                  Pharmacy
                                 Digitalization of
                                 prescriptions
                 Medication
Prescriptions    lists
                                                                                  Patient




                                                                                  Patient

                                                     Blimus -
                                                     Software


    Doctor                                                                        Patient
                                                                Nursing
                                                                 staff

                                                                 Medication
                          Hospital,                              distributed by
                         Retirement &                            dispensers       Patient
                        Nursing Home,
                         Care Home


   ACE 2011 INTERNATIONAL                                                           Slide 11
Benefits


 Care facility                              Patient
        Safe provision of medication            High level of medication safety
        High level of medication safety         Easy, convenient administration
        Lower stock of medication at the        No confusion between medications
         nursing station                          or dosage times
        Automated range calculation,            Continuous dosage and timely
         coordination of prescription             reminders of necessary
         management                               prescription refills
        Patient-individual monitoring of        Simpler control of the time of
         medication for interactions              administration and dosage
        Increased pharmaceutical safety         Greater mobility and flexibility
                                                  (vacation blister packs)
        Return of blister packs while
         complying with legal privacy
         requirements
        Lot tracking of each individual
         blister pack

ACE 2011 INTERNATIONAL                                                               Slide 12
DataSquare‘s Challenge


 Ensurance of legally valid signature
 Integration of a signature component
 Re-writing of parts of the old software
 A very tight time table


 Development of the Aras Innovator Signature Connector
        Protocols can be provided with qualified electronic signatures for legally valid
         undersigning
        Signature software and hardware is integrated in Aras Innovator
        Signature process is controlled by Aras Innovator
        Operation through the Aras Innovator client and entry of a PIN code at the
         terminal




ACE 2011 INTERNATIONAL                                                                  Slide 13
New Verification Process in Blister Pack
Production

 Automation of the production process
        Digital control and documentation of the verification and approval processes
        All-digital management and legally compliant archiving of the production
         protocols
 Entire Data Management in Aras Innovator


                                                   Service

                                Production
                                                         Pictures

                          Archive

                                    Protocols           Workflows


                                       Certifications



ACE 2011 INTERNATIONAL                                                              Slide 14
Aras Innovator‘s Task




ACE 2011 INTERNATIONAL   Slide 15
Workflow Control in Aras Innovator




ACE 2011 INTERNATIONAL               Slide 16
Signature Request


 Software approved by the Federal Office for Information Security (Bundesamt für
  Sicherheit)
 A batch is approved by a Qualified Person affixing authorized electronic signature
  to an approval protocol
 Aras Innovator clears the drugs for dispatch and initiates shipment of the specific
  batch via the workflow system; however, it does not create the signature and is not
  able to check this
 The signature must be created and checked by certified software; OpenLimit
  SignCubes software is used in the Aras Innovator Signature Connector for this
  purpose
 Aras Innovator automatically
  accesses this software




ACE 2011 INTERNATIONAL                                                              Slide 17
Electronic Signature Process


                                A “container“ is placed around the
                                 document; the signature is
                                 embedded in the container by the
                                 signature software
                                  (The hash value is encrypted by the smartcard‘s
                                  private key)

                                The container becomes invalid if
                                 there is any subsequent
                                 interference
                                This change is immediately
                                 recognized and notified
                                International security certification:
                                 Common Criteria EAL4+




ACE 2011 INTERNATIONAL                                                          Slide 18
PIN Code Entry


 The PIN code is entered via the smartcard terminal‘s keyboard
 The signature is created by pressing the green button after entering the
  complete PIN




ACE 2011 INTERNATIONAL                                                       Slide 19
Data Transfer to Aras Innovator


                                  Portrayal of the signature status in
                                  Aras Innovator lifecycle




ACE 2011 INTERNATIONAL                                                   Slide 20
Production Protocols




ACE 2011 INTERNATIONAL   Slide 21
Re-entry of Paper Protocols




                               Automatic text recognition by
                                OCR
                               Protocols automatically
                                allocated and sorted in Aras
                                Innovator by code recognition
                               Data automatically saved in
                                Aras Innovator

ACE 2011 INTERNATIONAL                                  Slide 22
Time Taken




In comparison to other PLM Systems: 2 to 3 times faster!

ACE 2011 INTERNATIONAL                                 Slide 23
Benefits


 Management                                          Legal requirements
           Centralized control and monitoring and          Personal liability of the entire
            therefore speeding up                            management
            of all processes                                Medical technology is shaped by a very
           Orders distributed to DBU blister                large number of legal requirements
            centers throughout Germany depending            The personal signature of a QP is
            on their workload                                required by law
           Time and costs minimized                        Legal obligation to retain documents for
 Resources                                                  10 years

           Qualified Persons (QPs) very expensive          Ongoing audits by the Association of
                                                             Statutory Health Insurance Physicians
           Several blister centers served by one            (KV) and Health Ministries
            QP  cost sharing
           Orders rapidly transferred to other       Operation
            QPs in the event of illness or holiday          Unskilled staff can be employed in the
                                                             Blister Center
 IT
                                                            Significantly less paper
           Central hosting
                                                            All orders processed faster
           Low maintenance requirement and
            less expense


ACE 2011 INTERNATIONAL                                                                            Slide 24
Many Thanks for your Attention
Your DataSquare Team


DataSquare GmbH & Co. KG
Hamburg/Germany
info@datasquare.de
www.datasquare.de

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Deutsche Blisterunion Germany Achieves Serialized Product Traceability with PLM from Aras Deployed by Datasquare

  • 1. ACHIEVING SERIALIZED PRODUCT TRACEABILITY FOR QUALITY & SAFETY Facing Compliance Requirements in the Pharmaceutical Industry and Personal Liability of the Management Joachim Misdorf CEO DataSquare Hamburg, Germany
  • 2. Company Deutsche Blister Union (German Blister Union) ACE 2011 INTERNATIONAL Slide 2
  • 3. Medication Supply Problem:  In 2009 we had 15 million hospital patients and 25 million in old people’s retirement & nursing homes worldwide (source: wikipedia)  Most of these patients need medication every day Current solution:  Thousands of nurses put pills into small pillboxes by hand every morning Consequence:  Procedure is very expensive  High Error Rate: Patients become ill or even die due to medication or dosage errors ACE 2011 INTERNATIONAL Slide 3
  • 4. Existing Process of Medication Supply Patient Pharmacy Prescriptions Medication in Patient transport packaging Patient Medication lists Nursing Doctor Patient staff Medication Hospital, distributed Retirement & by hand!!! Patient Nursing Home, Care Home ACE 2011 INTERNATIONAL Slide 4
  • 5. Legal Liability The risk for the CEO and the entire management is: Up to lifelong prison terms (US = lifelong / Europe = 10 years) plus full personal financial liability (worldwide) for failure to follow the regulations for medication supply  US Food and Drug Administration (FDA)  European Medicines Agency (EMA)  Plus local laws ACE 2011 INTERNATIONAL Slide 5
  • 6. What Does „Blistering“ Mean?  Solid, oral medication are provided in a one-week dispenser  Patient-individual medication supply  Name  Date & time  Kind of drug ACE 2011 INTERNATIONAL Slide 6
  • 7. Performance Characteristics  Capacity per site: Minimum 3,000 patients/week  Total capacity of the DBU network: Approx. 60,000 patients/week (Expansion stage 1)  Quality Assurance: Use of video scanners (each blister pack is photographed, analyzed and archived)  Drug safety: Patient information leaflet and tablet photo service  Training: Comprehensive training courses for nursing staff, patients and their relatives ACE 2011 INTERNATIONAL Slide 7
  • 8. Serialized Unit Packaging Information Name & date of birth of the patient Hospital ward Date & time of taking Dosage & name of the drug Kind of drug Product Code for Aras Innovator ACE 2011 INTERNATIONAL Slide 8
  • 9. Deutsche Blister Union  Service provider of dose-dispensed medicine  Germany-wide merger of blister pharmacies, regionally operating blister centers and industrial companies  Offers service on all aspects of the mechanical blistering of drugs for the individual patient  Founded in 2008  32 blister centers all over Germany in 2011  Market activities in the US since 2011 ACE 2011 INTERNATIONAL Slide 9
  • 10. Old Verification Process in Blister Pack Production  Documentation of the production process with production protocols  Distribution to “qualified persons“ (QP) throughout Germany  Protocols verified by QPs  QPs sign the protocols by hand to signify approval  Archived for over 10 years or for life / amount of paper increasing substantially QP QP Protocols sent for verification QP QP Production Protocols returned after verification QP QP Approved protocols archived Archive Takes a lot of time and very inflexible! ACE 2011 INTERNATIONAL Slide 10
  • 11. New Process for Medication Supply Patient Pharmacy Digitalization of prescriptions Medication Prescriptions lists Patient Patient Blimus - Software Doctor Patient Nursing staff Medication Hospital, distributed by Retirement & dispensers Patient Nursing Home, Care Home ACE 2011 INTERNATIONAL Slide 11
  • 12. Benefits  Care facility  Patient  Safe provision of medication  High level of medication safety  High level of medication safety  Easy, convenient administration  Lower stock of medication at the  No confusion between medications nursing station or dosage times  Automated range calculation,  Continuous dosage and timely coordination of prescription reminders of necessary management prescription refills  Patient-individual monitoring of  Simpler control of the time of medication for interactions administration and dosage  Increased pharmaceutical safety  Greater mobility and flexibility (vacation blister packs)  Return of blister packs while complying with legal privacy requirements  Lot tracking of each individual blister pack ACE 2011 INTERNATIONAL Slide 12
  • 13. DataSquare‘s Challenge  Ensurance of legally valid signature  Integration of a signature component  Re-writing of parts of the old software  A very tight time table  Development of the Aras Innovator Signature Connector  Protocols can be provided with qualified electronic signatures for legally valid undersigning  Signature software and hardware is integrated in Aras Innovator  Signature process is controlled by Aras Innovator  Operation through the Aras Innovator client and entry of a PIN code at the terminal ACE 2011 INTERNATIONAL Slide 13
  • 14. New Verification Process in Blister Pack Production  Automation of the production process  Digital control and documentation of the verification and approval processes  All-digital management and legally compliant archiving of the production protocols  Entire Data Management in Aras Innovator Service Production Pictures Archive Protocols Workflows Certifications ACE 2011 INTERNATIONAL Slide 14
  • 15. Aras Innovator‘s Task ACE 2011 INTERNATIONAL Slide 15
  • 16. Workflow Control in Aras Innovator ACE 2011 INTERNATIONAL Slide 16
  • 17. Signature Request  Software approved by the Federal Office for Information Security (Bundesamt für Sicherheit)  A batch is approved by a Qualified Person affixing authorized electronic signature to an approval protocol  Aras Innovator clears the drugs for dispatch and initiates shipment of the specific batch via the workflow system; however, it does not create the signature and is not able to check this  The signature must be created and checked by certified software; OpenLimit SignCubes software is used in the Aras Innovator Signature Connector for this purpose  Aras Innovator automatically accesses this software ACE 2011 INTERNATIONAL Slide 17
  • 18. Electronic Signature Process  A “container“ is placed around the document; the signature is embedded in the container by the signature software (The hash value is encrypted by the smartcard‘s private key)  The container becomes invalid if there is any subsequent interference  This change is immediately recognized and notified  International security certification: Common Criteria EAL4+ ACE 2011 INTERNATIONAL Slide 18
  • 19. PIN Code Entry  The PIN code is entered via the smartcard terminal‘s keyboard  The signature is created by pressing the green button after entering the complete PIN ACE 2011 INTERNATIONAL Slide 19
  • 20. Data Transfer to Aras Innovator Portrayal of the signature status in Aras Innovator lifecycle ACE 2011 INTERNATIONAL Slide 20
  • 21. Production Protocols ACE 2011 INTERNATIONAL Slide 21
  • 22. Re-entry of Paper Protocols  Automatic text recognition by OCR  Protocols automatically allocated and sorted in Aras Innovator by code recognition  Data automatically saved in Aras Innovator ACE 2011 INTERNATIONAL Slide 22
  • 23. Time Taken In comparison to other PLM Systems: 2 to 3 times faster! ACE 2011 INTERNATIONAL Slide 23
  • 24. Benefits  Management  Legal requirements  Centralized control and monitoring and  Personal liability of the entire therefore speeding up management of all processes  Medical technology is shaped by a very  Orders distributed to DBU blister large number of legal requirements centers throughout Germany depending  The personal signature of a QP is on their workload required by law  Time and costs minimized  Legal obligation to retain documents for  Resources 10 years  Qualified Persons (QPs) very expensive  Ongoing audits by the Association of Statutory Health Insurance Physicians  Several blister centers served by one (KV) and Health Ministries QP  cost sharing  Orders rapidly transferred to other  Operation QPs in the event of illness or holiday  Unskilled staff can be employed in the Blister Center  IT  Significantly less paper  Central hosting  All orders processed faster  Low maintenance requirement and less expense ACE 2011 INTERNATIONAL Slide 24
  • 25. Many Thanks for your Attention Your DataSquare Team DataSquare GmbH & Co. KG Hamburg/Germany info@datasquare.de www.datasquare.de