Transcript powerpoint presentation

“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
• 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
Greater Glasgow NHS Board
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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)
eMM Research & Context
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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
Project Planning
• Project Planning - Programme board, Project
management, Project Office
• Decision: To Pilot or Not?
• Project Briefs & PID for
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eMM Programme
eRx Pilot
OBS
Full Rollout
Community Pharmacy
Project Plans, Dependencies & Roadmap
Project Organisation Document
Communication Plan
Stakeholder Mapping
Project Planning – Stakeholder
Mapping
Royal
Pharmaceutical
Society in
Scotland
DoH
SCI
(Alan Hyslop,
Martin Irving)
SCI Store
(Alan Hyslop,
Martin Irving)
English
Government
CHI
Related
Projects
EMM
PROJECT BOARD
- GLASGOW
Virtual
IT
Team
Core
Hospital
Network
Upgrade
GPass
User
Group
Wirral
Early
Adopters
Derby
AAA
Community
Pharmacy
Contractor
Committee
GPass
Review
Group
Burton
Specific
Short Life
Working
Teams
Great
Yarmouth
User
Requirements
(Output Based
Specification)
Process
Mapping
Proof
of Concept
(Pilot)
Training
Testing
Support
Documentation
& Procedures
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DD
Synchronisation
Team
Community
Pharmacy
Possible
Procurement
Area
Clinical
Forum?
National
Working
Group on
Prescribing
Practice
NPF/
SMSAC
ASCRIBE
User
Group?
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SCIMP
Clinical
Effectiveness
Group
Community
Pharmacy
Contractor
Committee
Scottish
Spec
Working
Group
Suppliers
SG
ASCRIBE
GMC?
ADTC
Chief
Pharmacists
Group
Culture
Change/
Training
ECCI
PCT
ASCRIBE
NHSIA
BMA?
Medicine
Management
Project
Board
Asscoiation
Scottish
Trusts Chief
Pharmacists
(ASTCP)
Pan
Glasgow
Programme
Board
SEHD
(Charlie
Knox)
Action
Stations
Primary
Care MM
Project
AAA
ETP
Trials
GP-Community
Pharmacy Network
Project
Royal
College of
General
Practitioners
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Secondary
Care MM
Project
Full
Rollout
Testing
UK
Spec
Workng
Group
Community Pharmacy
• ETP Trials > Watching Brief
eRx Pilot
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Allow Time
Cost
24x7 support (IT, Pharmacy, Supplier)
Disaster Recovery Plan
Hardware & Technology Selection
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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
eRx Pilot
• Training
– IT Illiteracy & Phobia (Nurses)
– Application (on-call JHO)
– Superusers
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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
EPMA Pilot
• Scope change – Medicines Administration
More Risk but More Benefit
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
Medicines Management - Benefits
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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
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
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
EPMA Pilot
• Decision put EPMA pilot on hold – focus on
MM, Evaluation, Process Mapping & EPMA
OBS/Requirement spec.
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)
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
EPMA & MM OBS/Requirement Spec.
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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
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
Comparison NHS & Commercial
Commercial Organisation
NHS
Management authority & delegated
responsibility
Project management methodology
Experienced project manger
Vision
Few stakeholders
Ring-fenced resource
Tightly defined objectives & specification
Competition
Status
Quality management system
Management by committees & forums,
bureaucracy - Politics
Informal project management
User project manager, no training
Lot of ideas
No clear organisational picture & tentacles
Over-stretched resource
Flexibility to change mind
Collaboration
Passion, Commitment, Motivation, Belief
Resistant to change
IT money siphoned off
Conclusions
• IT is Change Enabler/Limiter
• Need Procedures to Change (People)
• Communication & Involvement is Key
EPMA & MM
– Tap into Committees (Be Seen/Accessible)
– Project Vision
• Pragmatic Project Management & Experienced PM
• Danger Too Much Change - Prioritise Projects
• Allow Time, Money & Resource
“Electronic Prescribing, Medicines
Administration and Medicines
Management: It’s not Rocket Science, is it?
Alan Heal
Web: WWW.TRANSPT.COM
E-mail: [email protected]