The Information Enabled Pharmacy

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The Information Enabled Pharmacy Opportunities
and challenges Tim Donohoe Group Programme
Director NHS Connecting for Health
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• Context
• What is the Information Enabled Pharmacy?
• How will the Electronic Prescriptions Service
  help?
• Implementation
• Beyond electronic prescriptions?
• Getting there further challenges
• Conclusions

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• Context

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Context

• Delivering 21st Century IT
• Experience of the pilots
• Opportunity to reassess drivers
• More emphasis on potential clinical benefits
• New contractual framework for community pharmacy
• Seamless integration with NHS Care Record Service

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Context

• Pharmacy IT is changing
• The new contractual framework
• Electronic Prescriptions Service
• The Information Enabled Pharmacy a fact of life
  in 3-5 years?
• The Electronic Prescription programme is paving
  the way for the transformation of pharmacy IT

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• What is the Information Enabled Pharmacy?

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Community Pharmacy ITFrom What?

• Multiple systems/vendors
• Disconnected
• From each other
• From the rest of the NHS
• From the patient organisation/system centric
• Islands of information locally held

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Community Pharmacy IT To What?

• Fewer systems in use
• Connected
• To the NHS Care Record
• To the rest of the NHS
• To the patient patient at the centre
• A global view of information
• Patient records
• Online information sources

The Information Enabled Pharmacy
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• How will the Electronic Prescriptions Service
  help bring this about?

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What is it?

• A new service for England that will
• Enable prescribing and dispensing information to
  be sent electronically
• Reduce reliance on paper prescriptions over time
• Allow patients to nominate a specific pharmacy if
  they wish to
• Update patient medication record in NHS CRS

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Why is it needed?

• The change from a paper-based to an electronic
  system for prescriptions is necessary because
• About 1.3 million paper prescriptions issued
  every working day
• predicted to rise by over 5 per annum
• About 70 of prescriptions are now repeats
• need a system designed with this in mind - more
  efficient and consistently accurate

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Why is it needed?

• To support pharmacists in providing a wider range
  of services
• To populate the NHS Care Record

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Benefits

• Patient choice and convenience
• Supporting the growth of repeat dispensing
• Reduced administration
• Better management of workflow
• Online cancellation

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IT projects are not about IT they are about
change
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The engineering challenge

• 10,000 pharmacies
• 9,000 GP practices
• 20 systems
• 130,000 users

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The engineering challenge

• Upgraded hardware
• Upgraded software
• Connectivity (to the NHS infrastructure)
• National standards for
• Security
• System interoperability
• Clinical terminology

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Implementation

• Objectives during delivery?
• The rapid and safe deployment of ETP into live
  service across England
• Maintain patient choice
• Logistical challenge
• Likely timescale?
• All key suppliers working towards compliance by
  late 2005
• Wider rollout
• Building capacity now underway
• Full functionality - complete end 2007

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Proposed implementation model

• A phased approach to deployment of functionality
  is proposed in order to
• Maintain patient safety and choice
• Ensure that lessons are learned as the roll out
  progresses
• Ease the implementation burden on users and
  patients

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Where are we now?

• Core software operational since December 2004
• Initial implementer sites operational
• Active user groups
• Wider roll out underway

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Initial Implementers

• First live site 21st February 2005
• Purpose?
• Technical assurance, safety case compliance
• Prove technical stability
• Examine impact on local processes in surgery and
  pharmacy
• Maximise workflow benefits
• Inform future system design
• More planned - each system supplier will do at
  least one initial implementation prior to wider
  roll out

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Keighley the pharmacists view
All the features of the technology mean that the
whole process of dispensing medicines is
streamlined and made easier Its difficult to
quantify, but Ive already seen a reduction in
potential dispensing/labelling errors, and we are
able to work faster and more efficiently Andrew
Murphy- Pharmacist, Co-op Pharmacy, Keighley
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Stakeholder involvement

• Purpose
• Consult about the design and the issues
• Communicate progress and benefits
• Deliver - a robust and well designed system - of
  benefit to patients, pharmacists and GPs
• Mechanisms
• Pharmacist user group
• GP user group
• Implementation reference group (PCT/SHAs)
• Patient user group

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User groups key topics

• Guidelines for implementation
• Communication approach
• Security and confidentiality (including roles and
  business functions)
• Changes in operational processes

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Beyond electronic prescriptions?
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NHS Care Record

• An electronic patient record
• Accessible by the professionals who need to see
  them - for example a doctor in AE or a different
  GP if a patient is taken ill on holiday
• Integration with the Electronic Prescriptions
  Service
• EPS data will be part of the patients care
  record

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Integration with CRS

• Full details of how EPS will be integrated with
  CRS are still under development
• Specifically, the extent of pharmacist access is
  still subject to consultation
• There will be a separate programme to explain CRS
  to the professions and to the public

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What will integration achieve?

• Information on what has been prescribed can be
  automatically recorded in the patients care
  record
• Information on what has been dispensed can be
  captured for the first time and held in the
  patients care record

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Getting there further challenges
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Getting there further challenges

• Culture and process change
• Access to information on Care Record
• Patient view of who should see what
• GP views
• Withholding sensitive information
• Rights and responsibilities of access to
  information
• Supplier capacity

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Conclusions
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Conclusions

• The Electronic Prescription Service is a major
  opportunity for pharmacy
• IT is a key enabler of change in pharmacy but
  it is only part of the challenge

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Questions?