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“Electronic Prescribing, Medicines Administration and Medicines Management: It’s not Rocket Science, is it? Alan Heal. “Electronic Prescribing, Medicines Administration and Medicines Management: It’s not Rocket Science, is it? Alan Heal. Background. Degree in computer science & MBA

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  1. “Electronic Prescribing, Medicines Administration and Medicines Management: It’s not Rocket Science, is it?Alan Heal

  2. “Electronic Prescribing, Medicines Administration and Medicines Management: It’s not Rocket Science, is it?Alan Heal

  3. Background • Degree in computer science & MBA • 22 years in IT • Every role – analysis, programming, support, quality, project management • Mostly commercial organisations • financial services, banking, retail, travel, manufacturing, telecommunications & consultancy • 3 years deputy group IT director – Lloyds pharmacy and AAH pharmaceuticals • Public sector • The Law Society (£40m transformation programme) • Social housing • 2001 set up Transit Point

  4. Greater Glasgow NHS Board • 1 year eMM Project Manager based in Glasgow • eMM Research • Project Scope, Planning, Costing & Startup • eMM Umbrella Programme • Community Pharmacy • eRx Pilot • Process Mapping • OBS/Specification of requirements • Initial shaping of Full Rollout (4200 beds, 232 ward, 20 sites)

  5. eMM Research & Context • EHR, EPR levels 1-6 & Timescales • National Service Frameworks (NSF’s) • Integrated Care Records Services (ICRS) • Procurement Rationalisation (NISP, NASP, LSP) • Confidentiality & Privacy • UKCPRS • SNOMED-CT • X NOT SCOTLAND • Spoonful of Sugar & Organisation with a Memory • Contacts

  6. Project Planning • Project Planning - Programme board, Project management, Project Office • Decision: To Pilot or Not? • Project Briefs & PID for • eMM Programme • eRx Pilot • OBS • Full Rollout • Community Pharmacy • Project Plans, Dependencies & Roadmap • Project Organisation Document • Communication Plan • Stakeholder Mapping

  7. Project Planning – Stakeholder Mapping

  8. Community Pharmacy • ETP Trials > Watching Brief

  9. eRx Pilot • Allow Time • Cost • 24x7 support (IT, Pharmacy, Supplier) • Disaster Recovery Plan • Hardware & Technology Selection • Mobile Devices & Robustness • Fast Moving, e.g., Smart Card • Thick/Thin Client, Web Based, Portal • Wireless LAN & Security • Size to Cover Peaks Plus Growth • Data Protection & User Authentication • Software Selection – Functional specialist cf. Generalist

  10. eRx Pilot • Training • IT Illiteracy & Phobia (Nurses) • Application (on-call JHO) • Superusers • Clinical Risk – Testing • Project Risk – Shortage of Nurses & Pharmacists • Drug Trolley Redesign • NHS Number & CHI Number • Choice of Pilot Site - General Ward not Critical Care • Evaluation 3 months

  11. EPMA Pilot • Scope change – Medicines Administration More Risk but More Benefit

  12. Medicines Management • MM structure • Overlap (Drug Trolley might Disappear?) • Definition • Original Packs • 28 Day Supply • Patient Lockers • Patient’s Own Medicines (Consent) • Medicine Re-use • Self Administration (Consent) • Responsibility from Clinician to Nurse & Pharmacist, Nurse Partly Covers Pharmacy Out Of Hours

  13. Medicines Management - Benefits • Speed up Discharge Process • Reduce Nurse Time on Supply & Admin • Automate process means more time NTPP • Better weekend Cover • Lower Cost through • Better Use of Drugs • Compliance (Self Administration) • Better Primary & Secondary Care Integration • Recent Example

  14. Medicines Management – Challenges & Opportunities • Timing - eRx then MM harder than MM then eRx • Patient’s Own Controlled Drugs • Primary/Secondary Care Costing • Changing SOP’s and Unions

  15. Medicines Management – Challenges & Opportunities • Flexible Systems • Technological Change (Robotic Dispensing) • Support Future Process Change • Stock Control of Patient Lockers • MA & Technician Check Trigger Re-Supply • Parallel Imports/Original Packs • Undo Button • Ward re-labelling

  16. EPMA Pilot • Decision put EPMA pilot on hold – focus on MM, Evaluation, Process Mapping & EPMA OBS/Requirement spec.

  17. EPMA & MM Process Maps • Map Processes - Current & Future (EPMA & MM) • High Level • Admission • Clinical Management • Drug Administration • IV Administration • Stock Management • Discharge • Cardiology (EPMA Pilot team) > Generic > HEMPA (Scottish Top 16 EPMA & MM Guidelines)

  18. EPMA & MM OBS/Requirement Spec. • EPMA/Pharmacy Close Coupling • Starting Point – Liverpool/Derby Generic Pharmacy & EPMA spec. • Turn into Scottish Document • 40 hours Multi-Disciplinary Workshops • Clinician Input Biggest Risk • Careful Wording • Piecemeal IT development • Standardisation • Consultants Don’t Always Agree

  19. EPMA & MM OBS/Requirement Spec. • Homeopathic & Herbal Remedies • System Integration & Interoperability • Single Login & Clinical Portal • Access to Pathology Results to • Make Informed Decision • Feed into DSS/Interaction Checking • Automatic Triggers • Extra System Flexibility/Configurability = Complexity, Cost, Unclear Process/Program Logic, RISK

  20. EPMA & MM OBS/Requirement Spec.Future • Link OBS to Process Maps (Patient Journey) • Wider Review – Stakeholders, Clinicians, Specialisms • Decisions on Legacy Systems • Once OBS agreed - complete Pilot and do Full Rollout

  21. Comparison NHS & Commercial

  22. Conclusions • IT is Change Enabler/Limiter • Need Procedures to Change (People) EPMA & MM • Communication & Involvement is Key • Tap into Committees (Be Seen/Accessible) • Project Vision • Pragmatic Project Management & Experienced PM • Danger Too Much Change - Prioritise Projects • Allow Time, Money & Resource

  23. “Electronic Prescribing, Medicines Administration and Medicines Management: It’s not Rocket Science, is it?Alan Heal Web: WWW.TRANSPT.COM E-mail: info@transpt.com

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