'Technology shaping the future

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Automation and the use of technology in the
supply chain.
'Technology shaping the future of Hospital
Pharmacy Services'
Judie Finesilver eBusiness Pharmacist September
26th 2007
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• Coding for Success
• eTrading
• Robotics and Automation

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Coding for Success

• Available to download

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The Vision

• Verify products
• through supply chain

• Verify right patient
• right intervention

Manufacturer
Finance Stock control
Audit

• Update patient
• record, stock control
• and audit

Wholesaler
Intervention
Patient Record
Healthcare Provider (stores)
Key
Patient
Clinician
Flow of items or people
Flow of data
Dr Helen Lovell
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The vision patients
Pathology/ Radiology
Pharmacy
Diagnostics
Medication

• Patient
• ID encoded on wristband
• Electronic Patient Record

Surgical procedures
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The vision medication
Electronic prescription
Patient ID encoded on wristband Electronic
Patient Record
Pharmaceutical manufacturer
Pharmacy
Doctor-patient consultation
Pharmacy checks
Medication
Wholesaler

• Unique product codes protect against counterfeit
• Track from manufacturer to patient through
  independent database
• E-prescribing and automated dispensing reduces
  errors
• Medication details entered into EPR through
  auto-ID.

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The vision diagnostics
sample
sample
Patient ID encoded on wristband Electronic
Patient Record
External laboratory
Pathology/ Radiology
Doctor-patient consultation
result
result

• Doctor orders tests electronically
• Technician matches patient to test using auto-ID
  verification
• Coded labels printed automatically for samples
• Results recorded directly into EPR and doctor
  e-prompted to review

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The vision devices
Device manufacturer
Surgical instrument
Implant
Patient ID encoded on wristband Electronic
Patient Record
Decontamination centre
Surgical procedures
Theatre

• Unique product codes protect against counterfeit
  and aid ID
• Track from manufacturer to patient through
  independent database
• Link to clinical audit systems e.g. National
  Joint Registry
• Linking stock control and EPR systems with
  finance system enables
• accurate records of cost per patient episode.

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Evidence patient safety

• Combined electronic prescribing, automated
  dispensing and bedside verification reduces
  prescribing (3.8 to 2) and administration
  errors (7 to 4.3) and patient ID checks
  increase from 17 to 81 (Charing X)
• Bar coding use in blood transfusions associated
  with reduced transfusion errors (Oxford)
• Vaccines use of batch no or expiry date in code
  form associated with reduced immunisation errors.
  (Canada)

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Evidence other benefits

• Cost savings
• Stock control cost per line of purchase order
  reduced from 7.05 to 39p when AIDC implemented
  (Leeds)
• Efficiency better management of patients
  through surgery allows more patients to be
  treated per session, saving 270K per year
  (Birmingham)
• Time savings
• Electronic verification of blood transfusion
  halves the total time for the procedure (Oxford)
• Increased job satisfaction
• Installation of dispensing robot reduces time
  spent on menial tasks, and reduces staff turnover
  (various)

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Progress in technology
Robotic dispensing
Coded wristbands on in-patients
Supplies and stock management
Verification of patient ID before test or
procedure
Decontamination - tray level tracking with bar
codes
Decontamination Individual instrument Tracking
(RfID)
Blood transfusion verification system
Established practice
Piloting and testing
Limits of technology
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Progress in implementation

• What do we have?
• gt90 of medicines have GTIN product codes
  devices more patchy.
• NHS fragmented mostly isolated applications.
• Underpinning systems (eg patient id) need
  to be more robust.
• 3. GS1 System offers best coding solutions

• What do we need?
• Manufacturers need to code products.
• NHS needs to use codes within wider systems.
• Agreement needed on common coding standard

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Action the balancing act
GS1 Membership and tech support
PASA / NHS SC contracting
Demonstrator projects
Guidance on underpinning issues (e.g.
wristbands)
NHS
Industry

• Industry is further ahead need to rebalance
  with more support
• to the NHS at this stage, before moving forward
  together.
• Work with HUG to shape GS1 coding standards for
  the future.

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Action summary

• NHS PASA / NHS SC contracting will be used to
  lever change in industry
• GS1 membership for NHS organisations, with
  demonstrator projects etc
• Further guidance on underpinning issues to NHS
• Update dmd to include product codes
• Work with HUG to shape coding standards for the
  future
• Review progress by end 2008.

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• eTrading

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eTrading

• UKPMS group.
• United Kingdom Pharmacy Messaging Service
• A key deliverable to send 100 of wholesaler
  orders electronically by 2008.
• Use of a single trading pathway
• eInvoicing returning to the NHS brings the
  benefit and savings back to the NHS.

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eTrading

• PASA funding for eOrdering and eInvoicing
  interfaces with either Medecator or PowerGate.
• Around 30 sites- mainly ASCribe and JAC
  (eOrdering only)
• eEnablement Booklet

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eTrading
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• Robotics and Automation

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Robotics and Automation
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• Useful resources for automation.
• Which hospitals are using which systems
• Contact details for the system suppliers
• Toolkit which provides a flow-diagram of
  processes to aid the installation of a system

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Which hospitals have which systems?
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Suppliers of Robotics Systems
Hgkhgkhg NHS PASA does not endorse any
one of these companies, and there is no
significance in the order in which they appear
here. There may be other companies who also
provide this hardware.  This is not an
exhaustive list
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Robotics Toolkit
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Flow Diagram to show
how to use the toolkit. Diagram
shows when each chapter becomes relevant to the
process
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PASA contracts helping with barcode problems.

• All tenders must be submitted with EAN detail for
  product
• Contract descriptions for products are following
  the dmd descriptions
• Form on the website to download, complete and
  return to us.
• http//www.pasa.nhs.uk/PASAWeb/Productsandservices
  / Pharmaceuticals/eBusiness/Robotics/LandingPage.h
  tm

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How you can help yourselves

• Ensure that the repackaging unit you use, is
  aware that you have a requirement for barcodes on
  your repacks and over-labelled products. ( tender
  for this service?)
• Barcodes on these products should mask the
  barcode on the original product. (obliterate the
  original barcode).
• Encourage them to make contact with GS1uk at the
  NHS Helpdesk 0808 178 8799 or www.gs1uk.org

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Birmingham

• A Hospital without a Pharmacy
• Automation
• Ward based supply
• Consignment stock

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Out-Patient Supply New Hospital

• Options
• Automated in house pharmacy in New Hospital
• Private sector run pharmacy
• Electronic transmission of prescriptions (ETP) to
  private sector supplier
• Homecare services

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Any Questions?

• More details can be found at
• http//www.pasa.nhs.uk/PASAWeb/Productsandservices
  /Pharmaceuticals/eBusiness/LandingPage.htm
• judie.finesilver_at_pasa.nhs.uk