Transcript Progress on Healthcare IT Developments in Wales Cheryl Way National Pharmacy and Medicines Management Lead Informing Healthcare Language Lesson ENGLISH WELSH Department of Health (DOH) Welsh Assembly Government (WAG) Connecting for Health.

Progress on Healthcare IT Developments in
Wales
Cheryl Way
National Pharmacy and Medicines
Management Lead
Informing Healthcare
Language Lesson
ENGLISH
WELSH
Department of Health (DOH)
Welsh Assembly Government
(WAG)
Connecting for Health (CfH)
Informing Healthcare (IHC)
National Spine
Welsh Clinical Portal (WCP)
Summary Care Record (SCR)
Individual Health Record (IHR)
HealthSpace
My Health on Line (MHOL)
NHS Wales
~£3bn
Budget
3,000,000
Patients
81,000
Staff
15,000
~2000
1
10
Assembly Trusts
22
LHBs
GP
Practices
Hospitals
135
Beds
Informing Healthcare - A national programme
funded by the Welsh Assembly Government

To make a shared view of clinical care available across NHS Wales:
An incremental approach – “the individual health record”

To support and coordinate the redesign of working practices to deliver patient
benefits:
Service improvement projects

To create a ‘world class’ technical infrastructure so that information can be
shared securely irrespective of organisational boundaries:
A national technical blueprint or architecture
A Shared View of Care
Individual
Health
Record
Welsh Clinical
Portal
Clinician access
-- where care
is delivered
GP systems
(lifelong record)
Current hospital
systems
My Health Online
Patient access
-- over the internet
New hospital/
community
systems
•Radiology IS
•Laboratory IMS
•Prescribing
•Scheduling
•Ordering
Welsh Clinical Portal
 A web “home-page” linking health computer
systems
 Will give healthcare staff a common way of
accessing varied systems that support patient care
in hospital
 Will be standardised across Wales
 Version 1 being tested in Cardiff and Carmarthen
 Designed in consultation with health professionals
 Being built by trust developers
Individual Health Record (IHR) in
out-of-hours (OOH) care
 Started in Gwent (SE Wales) in November 2006
 79 of 96 GP practices share information with OOH service
 Access via the Adastra system
 462,983 records available
 > 1 in 7 people in Wales
Next Steps
 Anglesey/Gwynedd (NW Wales)
 Ceredigion/Pembrokeshire (SW Wales)
 Going Live 1st July 2008
 800,000 patients by Summer 2008
 All Wales 2010
IHR in out-of hours (OOH) care Benefits
 A survey of clinicians working in the Gwent out-ofhours service showed that: >70% felt the IHR helped them provide tailored advice to
callers
 80% felt this when dealing with older patients or those
with chronic conditions
 It is helping out-of-hours GPs reduce the number of
callers referred to A&E or for hospital admission
Individual Health Record (IHR) in
Unscheduled Care
 Extended coverage within Gwent
 Went live in the Medical Admissions Unit at
the Royal Gwent Hospital on 30th April 2008
 Access restricted to MAU staff
 Includes MAU pharmacists
 Pharmacists “very excited” about the information
available to them on admission
My Health Online
 Trials started at 5 GP surgeries in October 2007





Anglesey
Bridgend
Cardiff
Llandysul
Swansea
 Patients can use the internet to
 Book appointments
 Request repeat prescriptions
 Access their own records (3 surgeries)
My Health Online
Benefits – patient time estimates
Functions
Phone
Call-in
Online
Prescriptions
8.9 mins
6.8 mins
4.7 mins
Appointments
15.9 mins
8.7 mins
4.8 mins
Queries
10.1 mins
8.4 mins
4.1 mins
My Health Online
Benefits – GP surgery time estimates
Prescri
ption
items
per
person
p.a.
% of
repeat
items
21
75
Repeat
items
per
practice
(6000
list
size)
94500
Repeat
prescri
ptions
per
practice
– 10%
take up
9450
Minutes
saved
per
practice
(1 min
per
item)*
9450
Weeks
saved
p.a.
% FTE
saved
p.a.
4.5
9%
* Feedback from 3 practices on MHOL pilot 2007-8
Medicines strategic approach:
Summary
Central Hosting of EDS System
Conversion
Pharmacy
Implementation
Electronic Medicines Management System
Development
Pilot
Portal Transcribing
Drug Coding
Drug
Code
Mapping
Link EDS to
Transcribing
Transcribing
Deliver
transcribing
via the portal
E-Prescribing of Chemotherapy
Fact Finding,
Specification &
Procurement
Implementation
E-Prescribing Service Improvement Project
Fact Finding,
Specification &
Procurement
Implementation
Inform Business
Case for
E-Prescribing in
Wales
E-prescribing
Hospital Pharmacy System Upgrade
 EDS pharmacy system used in all trusts except
Swansea (JAC and ASCribe)
 Trust servers last replaced in 1999, now failing
 System software rewritten in Cache in 2007
 Hosted on three central servers at two sites,
managed by Health Solutions Wales (HSW)
 Now live in five of the eight affected trusts
 Roll out across Wales by mid 2008
 Benefits – system resilience from back-up servers
 Risks - network failure
Medicines strategic approach:
Summary
Central Hosting of EDS System
Conversion
Pharmacy
Implementation
Electronic Medicines Management System
Development
Pilot
Portal Transcribing
Drug Coding
Drug
Code
Mapping
Link EDS to
Transcribing
Transcribing
Deliver
transcribing
via the portal
E-Prescribing of Chemotherapy
Fact Finding,
Specification &
Procurement
Implementation
E-Prescribing Service Improvement Project
Fact Finding,
Specification &
Procurement
Implementation
Inform Business
Case for
E-Prescribing in
Wales
E-prescribing
Electronic Transcribing
 Used by pharmacy staff to manage patients’ medicines from
admission to discharge
 Used as a reconciliation tool on admission (NICE, 1000 lives)
 Tracks changes to patients’ medication during in-patient stay
 Used to populate medication list at discharge
 Sent electronically to GPs
 +/- community pharmacists?
 Produces a reminder chart for patients
 Based on the e-script system developed in Shrewsbury using
FDBE’s Multilex drug file
 Will be accessed via the Welsh Clinical Portal
 Will be interfaced with EDS pharmacy systems
Transcription
(Create)
Current Medication
Medication
Status
CC
SS
Irbesartan 150mg capsules: Take ONE DAILY
1/4/08
Continued
DR
28
Atorvastatin 40mg tablets: Take ONE at NIGHT
28/2/08
Continued
!
POD
Bendroflumethazide 2.5mg tablets: Take ONE DAILY
6/2/06
Continued
DR
Counsel
Allopurinol: 300mg tablets : Take ONE DAILY
1/2/98
Continued
!
Clinical Check
Clarithromycin 250mg tablets:Take ONE tablet TWICE DAILY
19/4/08
Started on admission
DR
14
CI
Add
Started
Edit
Stop
AC
Pharmacy Note
Note
Re-start
Date
Drug
31/10/2015
Atorvastatin 40mg tablets: Take ONE at NIGHT
31/10/2015
Allopurinol: 300mg tablets : Take ONE DAILY
Note
Init
Consider stopping whilst patient is taking calrithromycin
DR
Patient stated that they have stopped taking this Drug. Please review.
AC
Medication Stopped on this Admission
Medication
Bisoprolol 2.5mg tablets: Take ONE tablet TWICE DAILY
Status
Reason
Date
Cancel
Stopped
Pt bradycardic
29/4/08
Next >
Medicines strategic approach:
Summary
Central Hosting of EDS System
Conversion
Pharmacy
Implementation
Electronic Medicines Management System
Development
Pilot
Portal Transcribing
Drug Coding
Drug
Code
Mapping
Link EDS to
Transcribing
Transcribing
Deliver
transcribing
via the portal
E-Prescribing of Chemotherapy
Fact Finding,
Specification &
Procurement
Implementation
E-Prescribing Service Improvement Project
Fact Finding,
Specification &
Procurement
Implementation
Inform Business
Case for
E-Prescribing in
Wales
E-prescribing
Welsh Assembly Government
Primary Care IM&T Programme
 Community Pharmacy IM&T Programme
 Electronic Transfer of Prescriptions (ETP)
 2DRx project for Wales
 Connectivity to Health of Wales Information
Service (HOWIS)
 NHS e-mail address
 Electronic Transfer of Claims (ETC)
 To the Prescribing Services Unit (PSU) of Health
Solutions Wales (HSW)