Transcript Choose Pharmacy - Community Pharmacy Wales

Choose Pharmacy Application
Purpose:
1) Provide Project Background
2) Provide Overview of Application
3) Next Steps: Project Go live
4) Questions & Answers
DMR ICT Proof of Concept Project
Background:
•
Bid submitted to the WG Health Technology and Telehealth Fund (HTTF)
• Allowing CP to access the medicines information in electronic Discharge Advice
Letters (DAL)
• Generated by the national Medicines Transcribing and electronic Discharge
application (MTeD) only
• To support and complete electronic Discharge Medicines Reviews (DMRs)
• Improving and strengthening communication and electronic links with Community
Pharmacies (CP)
• To reduce medicines wastage and patient harm
• Improve the quality and safety of hospital discharges
DMR ICT Proof of Concept Project
Background:
•
During a inpatient stay in hospital, medicines may be changed/stopped (dose,
frequency, route)
•
Evidence: discrepancies arise between medicines a patient is prescribed on
discharged and the medicines prescribed in primary care
•
A review of 252 discharges in Wales identified:
• 148 discrepancies (58%) including 82 which were unintended (33%)
• 31 minor
• 21 significant
• 22 serious
• 8 life threatening
DMR ICT Proof of Concept Project
Background:
•
Discharge Medicines Review (DMR) service launched in Nov 2011.
•
Sharing information about a patient’s medicines at discharge with their community
pharmacy
•
Allows the pharmacist and patient to reconcile and talk about the patient’s medicines
•
Community pharmacist (CP) receives paper Discharge Advice Letters (DALs) and
checking medicines prescribed by GP matches information in hospital DAL.
•
Paper based DAL is struggling
• Often unavailable, incomplete or illegible
DMR ICT Proof of Concept Project
Choose Pharmacy
HTTF ICT Solution:
•
Developed a web-based application called “Choose
Pharmacy”
• Building upon and rebranding Common Ailments Service (CAS)
•
Facilitates the electronic availability of MTeD Discharge Advice Letter (DALS)
•
Community Pharmacists to complete eDMR interventions
•
DMR service can be optimised through real time sharing of electronic discharges
•
Made in Wales
•
Sponsored by Welsh Government Chief Pharmaceutical Officer
•
Deliver a proof of concept by March ‘15
Choose Pharmacy
• Why introduce an Electronic System?
•
Role of Community Pharmacy has evolved from one of dispenser to generic health provider
•
Systems have become efficient at supporting traditional delivery of medication
•
Inadequate: inconsistent sharing of information with community pharmacy identified as a common
problem
•
Current challenge: enable consistent and real time patient information sharing between healthcare
professionals
•
Choose Pharmacy offers an advancement in connecting Community Pharmacies with
secondary care
•
Key building block towards:
• Better sharing and transfer of patient information by improving IT connectivity
• Improving communication and availability of patient discharge advice letters to optimise DMR
service
Choose Pharmacy
• Why introduce an Electronic System?
•
Problems when paper DAL late, inaccessible, or incomplete
• Failings compromise patient safety;
• Continuation of drugs that have been stopped/changed
• Adverse drug reactions and;
• Hospital readmissions
•
Paper DALs prone to human errors, limited information and often illegible
•
Introducing Electronic system:
• Facilitate faster, real time sharing of DALs (removal of delay and processes with paper)
• Reduces the need to print, post and fax DALs (capacity and cash releasing benefit)
• Reduction in lost / misplaced paper DALs
• Greater security – enforces access security controls and audit (username and password)
Choose Pharmacy
• Why introduce an Electronic System?
• Sections of the eDMR form automatically populated from eDAL
• Connects patient data across systems, services and health sectors
• Essential step towards the bigger picture of supporting HIE across services and health
sectors
• Information follows the patient wherever care is provided
• Removing information “lock down” within Health Boards and Hospitals
• Strengthens communication links with Community Pharmacies (CP)
Choose Pharmacy
Demonstration Scenario:
1) Patient discharged from hospital and nominating a community pharmacy
2) Alert sent to a nominated community pharmacy
3) Community Pharmacist (CP) logging on and viewing a CP eDAL
4) CP initiating/completing an electronic DMR
Choose Pharmacy
Secondary Care:
Discharging a Patient via national
Medicines Transcribing and e-Discharge (MTED)
Secondary Care: CP DAL Notification Process
Ready for Discharge
Current Medication
Stopped Medication
Choose Pharmacy
Secondary Care: CP DAL Notification Process
Community Pharmacy preferences panel
Secondary Care: CP DAL Notification Process
If consented,
DMR
Patient
Preferences
asked
for interact
consent
with the registry of
pharmacy
selected
a patient
within
the Choose Pharmacy
application
Secondary Care: CP DAL Notification Process
When discharged, triggers an “ENAS Alert” email
ENAS Alert Email: Nominated Community Pharmacy
ENAS alert email sent to nominated community pharmacy
 ENAS Alert email prompts user to login into Choose Pharmacy application
 ENAS Alert does not include Patient Identifiable Information (PII)
Community Pharmacist Workflow:
Logging into Choose Pharmacy application
Choose Pharmacy Log in Screen
Previously CAS
GPhC number
- User Guide;
- FAQs;
- Help;
- Privacy Statement
PPA
Pharmacy information
Confirm location
Home Page
CAS Rebranded
1.
2.
CAS
DMR
Notifications
More Services........
Start DMR for a registered patient
Choose Pharmacy Home Page
CAS Rebranded
Since receiving DAL
Notifications
Unopened Discharge Advice Letters
Patient List View
Date Received
Patient Demographics
New DMR
DMR History
DMR History
1. GP and Patient Details
2. Discharge Details
3. DMR Part 1 and 2 outcomes
4. Can be printed
New DMR
DAL panel becomes active
Patient Consents
Community Pharmacy Discharge Advice Letter (DAL)
1. GP and Patient Details
2. Admission and Discharge Details:
Date, Time, Method, source and site
3. Medications at discharge
4. Medication stopped: Name and Reason
Discharges details and medications
list auto populate
form
If tick eDMR
box selected
eDMR Form Part 1
DMR Part 1
Information by:
Eligibility Criteria:
Method part 1 provided:
Number of meds on DAL
Number of meds taking
Medications
Discrepancy
Action
eDMR: Corrective Action
Number of
Follow Up
discrepancies
Actions
Submitting eDMR
Save Progress until Part 2 completed
Discard Changes
Submitting eDMR
Indicate if discrepancies
resolved
Enter Part 2 info
Submit DMR
Choose Pharmacy Home Page
CAS Rebranded
Sign Out
De-Register
Counters will reduce
DMR Evaluation: 17th July 2014
• Major barriers for CP and Hospital Pharmacists to engage in service:
1) Inability to identify eligible patients – they don’t know when they are discharged
Response: ENAS Alert sent for registered patients initially. Second phase, patient nominates in
hospital
2) Lack of access to discharge information or if it is received, timing of it is too late
Response: Access available to MTED E-DALs. Real time availability
3) Hospitals not referring patients and communication between sectors is poor
Response: MTeD enhancement to include community pharmacy preferences
4) Paperwork is not user-friendly and there is too much of it
Response: DMR Part 1 form streamlined. Auto populated if e-DAL available
5) No computer system in secondary care which supports DMRs
Response: MTeD enhancement to include community pharmacy preferences
Choose Pharmacy
• Next Steps
• Pilot commenced 24th March ‘15
• Choose Pharmacy eDMR pilot with 10 x CAV pharmacies
• Positive feedback
• No longer need/can enter claims in NECAF
• DMR part 1 form streamlined
• Reduction in data entry if eDAL available
• Improved availability of DALs (pushed)
• Better collaboration and sharing of information secondary > primary care
• Extend to BCU West and Cwm Taf (existing CAS sites)
• Conduct Evaluation
Stakeholder Feedback
DMR Part 1 form
easier and quicker
to complete
No need to enter
medicines
information!
Frees up time
(No need to enter
claims into
NECAF)
User Friendly and
simple to use
SUMMARY
•
WG HTTF project
•
Building upon Common Ailments Service (CAS) and MTeD application
•
Rebranded to ‘Choose Pharmacy’
•
Enable accredited CP to access an abstracted DAL generating by MTED only at the point
of discharge
•
To support an electronic DMR intervention to ensure correct medications are dispensed
for patients
•
•
Help prevent readmissions into hospital caused by medication errors
Timescales: Pilot commenced with CAV; planning to upscale to BCU West and Cwm Taf
QUESTIONS