Transcript Document

The Challenges of Having
Multiple ePrescribing Systems
Nick Hubbard
SafeMeds (EPMA) Pharmacist
WAHT
What is the Issue?
Separate EPMA solutions for core and
chemotherapy prescribing:
• Core prescribing on Noemalife solution.
• Chemotherapy on Elekta Impac Mosaiq.
• But relevant to most combinations.
Systems not interfaced or integrated.
Research
Literature search
Colleagues within West
Midlands
Trusts outside West
Midlands
NHS England
National Conferences
• Nothing
• Almost nothing (One EPR)
• Nothing (but concerned)
• Nothing on eprescribing toolkit
• Same
High Risk Patients
High risk patients
High risk drugs
• Immunosuppressed
• Other significant pathologies
• Other significant treatment
• Toxicity
• Interactions
• Need for adjunct therapy
Technology Problems
Different drug catalogues:
• Core uses DM+D.
• Chemotherapy uses in house.
Different DSS support systems:
• Core uses FDB (currently allergies, duplicates and interactions
at WAHT).
• Chemotherapy uses in house for allergies only.
Data source for discharges.
Clinical Problems
Missed allergies,
duplicates and
interactions.
Prescribing by
junior doctor out
of hours.
Identification
and
management of
ADRs.
Hard to keep
overall picture
as no single
record.
Split
administration
records.
Adjunct therapy
on both system risk of duplicates.
Practical Problems
Maintaining and
updating
separate drug
catalogues.
Prescribing of
EoL/palliative
care drugs.
Some drugs
may also be on
paper systems
eg INR charts.
Junior staff
prescribing out
of hours.
Links with
relevant lab
results.
Keeping track of
what has been
given/taken.
Potential Solutions or Work
Arounds
Single EPR – (the fortunate few!).
Interface or integrate systems.
View on multiple screens.
Print off one chart for cross checking.
Place holder for all drugs on core system.
Place holder for chemo only on core system.
Place holder for adjunct only on core system.
Summary – Moving Forward
Sorry
• No solutions offered.
Just points you may
need to consider.