EMIS dm d Implementation

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EMIS dmd Implementation

• Dr Jonathan Meadows

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The EMIS Drug Database

• Part of the EMIS clinical product supporting
  prescribing and dispensing within Primary Care
• Comprehensive (covering primary care prescribing)
  
• Up to date (Team of operators and efficient EMIS
  patch mechanism)
• Accurate drug knowledgebase (including BNF data)

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Current EMIS Database

• Lists all currently available UK licensed
  products including Drug Tariff of England Wales
• Each preparation description approved name
  form strength
• eg Amoxicillin Tablets 500 mg
• This allows grouping under approved names or
  within the EMIS Drug Groups (similar to BNF
  hierarchy)
• Each supported by constituents (also coded)
• Considerable number of attributes for prescribing
  and dispensing

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EMIS Database Maintenance

• Database managed by qualified team. Application
  allows rapid updating.
• New data requests are added to the central
  database and can be placed on the distribution
  update system (EMIS Patch) within 8 hours.
• Within 48 hours 75 of sites will have a new
  addition or other field property change (GV PCS
  100 in 24 hours)
• Approximately 15,000 GPs collect update within 7
  working days

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EMIS Data Model
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EMIS dmd Implementation
Phase I, Mapping Exercise
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Automation of dmd Processing

• Automate wherever possible
• Scheduled collection of each weekly update of the
  dmd release from the PPA web server, with
  processing into an EMIS staging database using
  SQL Server Data Transformation Services
• Unmatched VMP and AMPs are fed into the Drug
  Matching Application

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EMIS Mapping Exercise

• Qualified pharmaceutical clinical staff
• Specific mapping tool developed with implicit
  rules
• One to one mapping enforced
• Retirement of unmatchable EMIS preparations
• New additions to EMIS of equivalent dmd
  descriptions
• QA exercise, every mapping is scrutinised by two
  clinical teams operating independently within the
  Department of Coding and Drug Information.
• Further validation by PPA, possible extension of
  the NHSIA Read Map Validation Service
  IA-03-0214 to apply to dmd
• Following validation process commitment of each
  approved mapping will then made into the
  distributed Clinical Systems

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EMIS Drug Match Utility
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EMIS Phase I Implementation

• Phase I has little impact on existing clinical
  system algorithms and application code that
  relies on
• BNF Group and Emis Drug Group codes
• Approved name / Drug form / preparation codes
• Manipulation of existing codes provides user
  picking lists, alerts, interaction checking, pack
  and price and decision support information (BNF)
• Phase I will allow FP10 dmd coding as specified
  in the Implementation Guidelines using both the
  dictionary long name and SNOMED CT identifier

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Interoperability (FP10) and the PPA

• For each FP10 item
• (current proposal)
• On a separate line Right Justified SNOMED CT
  identifier
• Followed by the dictionary long name
• Dosage and quantity information

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Phase I Progress

• 60 - 3107/5173 VMPs (5995)
• Multi-constituent generic descriptions
• Generic appliances/dressings
• 43 - 4915/11321 AMPs (14025)
• ACBS products
• Appliances
• Actual generic products (Name Manufacturer)
• Target for June 2004
• Full Mapping at VMP/AMP level
• SNOMED CT code on FP10

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EMIS Phase II Implementation

• Full integration of the dmd into the EMIS
  products
• Mapping of constituents
• Forms
• packs
• Why?
• Enable clinical system interoperability between
  diverse clinical systems for exchange of
  information on medicines and devices.
• To bring in benefit from the additional
  information elements
• Decrease the required maintenance of the EMIS
  Drug Database by using a nationally recognised
  product
• Latter half of 2004