Digitising Medication Runs for Safer, Faster and More Accurate Clinical Administration
Client: Virginia Medical Supplies
Industry: Healthcare, Nursing Home Operations, Medication Management
Services: Technical Consulting, UX/UI Design, Offline-First Mobile App Development, Database & Web Service Integration, Security Implementation, System Deployment & Support
Overview
Virginia Medical Supplies engaged ERS to design and deliver a specialised mobile application to assist nursing home staff with the accurate, timely and compliant administration of medications. The Medication Administration Mobile Application (MAMA) was envisioned as a tablet-based digital tool to replace manual MAR (Medication Administration Record) processes and provide real-time insight into each nurse’s medication run.
At the heart of the solution was the need to integrate seamlessly with the existing Nu-Life Portal, synchronising patient data, cardex records, MAR charts and medication reviews to ensure that every medication run is performed with accurate information.
The Challenge
Medication administration in nursing homes is a time-sensitive, high-risk process that must be executed with precision. Nurses depend on up-to-date patient records, accurate MAR charts and clear cardex instructions to deliver doses correctly. Traditionally, these tasks were supported by paper records or desktop-based systems that did not adapt well to the dynamic working environment on the floor. Errors or omissions—such as incomplete runs, missed medications or unrecorded exceptions—could remain unnoticed until after the fact, creating potential clinical risks.
Virginia Medical identified several operational gaps that required a digital-first solution. Nurses often worked in areas with no reliable Wi-Fi, making real-time portal access impractical. Medication runs required not just recording the administration of individual drugs but also capturing timings, exceptions and interruptions, all of which are critical for compliance and governance. Complicating matters further, multiple nurses might work overlapping shifts, and an incomplete morning medication run could easily go unnoticed before the next run started. Detecting anomalies—such as unusually fast delivery times, skipped patients or inconsistencies with expected timing windows—depended on manual supervision rather than objective data.
Additionally, cardex records needed to be editable in the field, yet any change required strict approval workflows involving doctors, nurses, pharmacy validation and dual sign-off when necessary. A secure, structured system was required to manage these changes and ensure they reached the Nu-Life portal in a controlled manner. Finally, all sensitive data stored on the device needed to be encrypted for compliance and patient safety.
Virginia Medical required a robust, offline-first mobile solution capable of enforcing structured workflows, capturing granular timing data, and providing the accuracy, reliability and auditability essential for modern clinical care.
Our Solution
ERS designed and delivered MAMA as a comprehensive medication administration platform tailored specifically for nursing home workflows. The project began with a deep analysis of clinical processes inside the Nu-Life ecosystem, mapping how patient data, MAR charts, cardex entries and medication reviews interacted. This ensured the new mobile application could replicate and improve on established nursing practices while maintaining full alignment with regulatory and auditing standards.
Working from this foundation, ERS created a tablet-optimised Android application that enables nurses to carry out medication runs with clarity and structure. Patient information, cardex details and one month of historical and current-cycle MAR data are synchronised from the Nu-Life portal into the device, allowing nurses to operate fully offline. Every action—from selecting a patient to administering individual medications—is recorded locally with precise timestamps. This level of detail allows senior staff and management to identify missed doses, incomplete runs or irregular administration patterns once data is synchronised back to the portal.
The medication run workflow was designed to mirror the natural steps taken by nursing staff. Nurses log in to begin a run, browse a filtered list of patients by name or room, and open detailed medication screens organised through a simple tabbed layout. Throughout the run, they can apply quick reasons for non-delivery—such as patient illness or refusal—to speed up documentation while maintaining accuracy. Once medications are administered physically, the nurse records each one within the app before completing the patient. As patients are finished, they disappear from the active run, reducing clutter and guiding the nurse through a clean, structured sequence. At the end of the run, the nurse signs digitally to confirm completion, establishing a full audit trail.
ERS also implemented a flexible cardex management system, allowing clinicians to review, update and sign changes directly on the tablet. The app enforces correct workflow logic: doctors may sign off cardex changes; nurses may update records but require co-signing if a doctor is unavailable; and no change becomes active until approved by pharmacy. This ensures that cardex integrity is maintained across all stakeholders while still giving field staff the agility they need.
To keep patient data secure, ERS implemented 128-bit encryption at rest and established a controlled offline-first architecture that stores all data locally during runs. Once a connection becomes available, a suite of custom web services synchronises the recorded data back to the Nu-Life portal, updating MAR charts, patient histories and timing analytics. This synchronisation layer became a critical component of the solution, ensuring consistency, avoiding data conflicts, and providing management with a clear, timestamped view of how each run was executed.
For operational flexibility, ERS also included a configuration panel allowing nursing home staff to assign or update room and bed locations, improving efficiency during medication rounds. By combining all of these features into a single, intuitive interface, ERS delivered a platform that ensures medication administration is accurate, logged, analysable and clinically safe.
The Result
The MAMA application introduced a new level of structure, visibility and accountability into nursing home medication workflows. Nurses now carry out their medication runs with clear access to every patient’s cardex and MAR information, even in areas without internet coverage.
For management and clinical governance teams, the availability of granular timing data provided a powerful new way to identify non-delivery, detect anomalies and gain insight into day-to-day medication practices. The ability to track patient-level and run-level timings has significantly strengthened oversight, helping ensure compliance across all administered medications. The controlled cardex update workflow has likewise improved record accuracy, ensuring that all medication instructions are verified and approved before being applied.
The project demonstrates how ERS can take a highly specialised clinical process and translate it into a reliable, secure and user-centred mobile application that meaningfully improves patient care and operational governance.