Medication Management Creating the Future

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Medication Management Creating the
Future Electronic Prescription Service Dr
Manpreet Pujara Clinical Director
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EPS - a definition
The Electronic Prescription Service enables
electronic prescriptions to be generated,
transmitted, received and once dispensed against,
sent to the reimbursement agency for payment.
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Where will the EPS be used?

• Now
• GP practices (including dispensing practices)
• Community pharmacies
• Dispensing appliance contractors
• In the longer term
• Other primary care settings where prescribing and
  dispensing take place (dental practices, walk-in
  centres)
• Secondary care?

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Activity Summary

• Prescribing
• Over 172m prescription messages to date
• Up to 40 of national daily volume
• Dispensing
• 12.8m EPS messages downloaded
• 9.6m EPS messages dispensed
• 5 - 8 of total prescriptions dispensed via EPS

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Release 2
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EPS Release 2
Nomination
Advanced Electronic Signatures
Cancellation
Electronic reimbursement
Electronic repeat dispensing
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Advanced Electronic Signature

• In Release 2 prescribers will apply advanced
  electronic signatures to prescription messages.
• Unique to individual users and are applied using
  their Smartcard and passcode.
• It is the application of the advanced electronic
  signature to the electronic message that turns it
  into an electronic prescription.

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What is nomination?
Nomination is a new process that will give
patients the option to choose, or nominate a
dispensing contractor(s) to which their
electronic prescriptions can be sent
automatically Nomination can be likened to
existing prescription collection services, but
with an increased choice of dispensing
contractors
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The nomination process
Patient or their representative
can set their nominated dispenser at any EPS
location
up to 3 dispensers
Dispensing GP Practice
GP
Community Pharmacy
Dispenser
Appliance Contractor
HealthSpace
Patients can view the status of dispensers online
at www.nhs.uk
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Electronic cancellation?

• Electronic cancellation enables a prescriber (or
  authorised person in the GP practice with
  cancellation rights on their smartcard) to cancel
  an electronic prescription at any point prior to
  it being dispensed.
• GP clinical systems will allow cancellation of
  either whole prescriptions or individual items on
  that prescription
• A reason for cancellation must be given, when a
  dispensing contractor attempts to retrieve the
  prescription they will be notified of
  thecancellation and the reason

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Electronic repeat dispensing

• Release 2 of the Electronic Prescription Service
  will support the repeat dispensing process.
• Repeat dispensing allows a prescriber to
  authorise several issues of a repeat prescription
  at once.
• This means that the patient doesnt have to go
  back to their GP each time to collect a repeat
  prescription.
• Electronic repeat dispensing is possible from a
  single electronic prescription

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Electronic Submission of reimbursement
endorsements
Instead of having to batch and send paper
prescription forms to the reimbursement agency at
the end of the month, Release 2 will allow
dispensers to electronically submit reimbursement
endorsement messages for dispensed electronic
prescriptions.
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Benefits
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Extent of benefits willdepend on

• Proximity of patient, GP practice and dispenser
• Volume of repeat prescriptions a GP has to issue
• the current availability of prescription
  collection and delivery services
• the range of services a dispenser wishes to
  offer patients
• the potential for increase in the use of repeat
  dispensing

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Benefits for patients

• Reduction in trips to GP practice just to collect
  a piece of paper particularly those on repeat
  medication
• Greater freedom of choice making it simpler for
  them to use a dispensing contractor convenient to
  them
• Potentially, it could reduce pharmacy waiting
  times if electronic prescriptions are received
  and prepared in advance
• Extent of benefits are dependent on individual
  circumstances

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Benefits for prescribers

• Reduction in workload generated by patients
  requesting and collecting individual
  prescriptions
• Easier to make wider use of the repeat dispensing
• Ability to sign prescription electronically
  making the prescribing process more efficient
• Ability to cancel prescriptions electronically at
  any point up until they are dispensed and
  provide a reason for doing so

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Benefits for dispensers

• Provide scope to streamline workflow and manage
  stock control more effectively
• Contractors offering prescription collection
  services will no longer need to physically
  collect prescriptions for patients who have
  nominated them
• Electronic reimbursement endorsements will reduce
  the volume of paper that needs to be sorted and
  posted each month

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Smartcards
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Release 2 smartcards are a step to NHS CRS access
Single Card, Policy requires CRDB Approval
Single Card, Policy RA01 CRDB Approved
Viewable access to the medication record
Shared Card, Policy EPS01
Simple trace and update Messaging Access to PDS
Simple trace and update Messaging Access to PDS
LEVEL OF AUTHENTICATION
Access to EPS as a messaging service
Access to EPS as a messaging service
Access to EPS as a messaging service
Spine Authentication
EPS Release 1
EPS Release 2
Future
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Dispensing Supplier progress

• CFH EPS web site contains latest information
• Suppliers not shown havent made their plans
  known
• Latest dates provided by suppliers for initial
  implementation

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Next Steps

• A range of preparation activity has already taken
  place in initial implementer PCTs
• EPS plan to start testing the first GP Pharmacy
  systems later this month.
• Potential GP and Pharmacy sites have been
  identified - these will be confirmed just before
  going live, once the availability of compliant
  systems is confirmed."

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What should you do now?
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As a dispenser

• If you have yet to arrange an upgrade for Release
  1, contact your system supplier as soon as
  possible
• Where volumes of Release 1 prescriptions are
  still low talk to your local GPs
• Talk to your system supplier about their rollout
  plans for Release 2
• Start considering the impact of EPS Release 2 on
  existing business processes. This is key to
  maximising benefits.

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Questions? Answers _at_ www.cfh.nhs.uk/eps