conceptualising and developing a business case for hepma systems round table discussion · 2016. 8....

Conceptualising and developing a business case for HePMA systems

Round table discussion

Professor Aziz Sheikh

The University of Birmingham

24th September 2012

NIHR Programme Grant for Applied Research

Overview

Hospital ePrescribing and

Medicines Administration

(HePMA) systems

Outline of our programme of

work

Structure, organisation and aims

of the workshop


HePMA systems

“The utilisation of electronic systems to facilitate and enhance the communication of a prescription or medicine order, aiding the choice, administration and supply of a medicine through knowledge and decision support and providing a robust audit trail for the entire medicines use process” (NHS Connecting for Health)

Anticipated benefits: patient safety, clinician benefits, service benefits


Aims:

To describe and understand the procurement, implementation, adoption and maintenance processes involved with introducing ePrescribing systems.

To estimate their effectiveness and cost-effectiveness.

To develop best practice recommendations and a toolkit for their successful integration into NHS hospitals.

Investigating the implementation of ePrescribing systems into NHS hospitals


Our research team


Prof Anthony Avery

Dr Sarah P Slight

Prof Aziz Sheikh

Prof Robin Williams

Prof Jill Schofield

Zoe Morrison

Dr Kathrin Cresswell

Dr Ann Robertson

Dr Jamie Coleman

Prof Richard Lilford

Dr Jonathan Shapiro

Dr Lily Yao

Antony Chuter

Ann Slee Prof David W Bates


Four Work Packages (WPs)

Work package 4Integration across WPs to develop recommendations and a toolkit for the NHS

Interlink the qualitative and quantitative components;

develop a detailed typology of existing systems and their capabilities

Work package 3Health economics and a value of investment analysis

Estimation of costs (including opportunity costs) of computer systems

of different types; framework for cost categories

Work package 2 Assessing impact on prescribing safety

Stepped-wedge design evaluation with 6&12 months follow-up analyses

of prescribing indicators

Work package 1Procurement, implementation, adoption and connectivity

Documentary data, semi-structured interviews, on-site observations, field notes ethnography

Patient and public

involvement

Lots of national interest and planning…


Questionnaires distributed

Returned (representing

55 Trusts)

Implementation

plans

108

Yes (n=85)

re

No (n=23)

Already

implemented

(10 Trusts,

18%)

Currently

implementing

(11 Trusts,

20%)

Planning to

implement/pr

ocuring (30

Trusts, 55%)

No current

plans of

implementing

(4 Trusts, 7%)

Increasing range of system choice…


But…

Relatively limited expertise within individual hospitals

With the demise of NHS CFH, little in the way of central

guidance, standards or support


Need for opportunities for sharing ideas/experiences/insights

“In my journey so far it is very important to determine a

clear set of criteria which all systems must comply with.

This is a huge problem.”

“Need a clear criteria of functionality this is a must and

which is evidence based.”


Systems choice

“…one of the problems when you’re assessing a system is there’ll be

systems that have been around for 4 or 5 years, there’s the one that’s

relatively current and there’s the new kid on the block. The ones that

have been around for a long time are based on relatively old

code…old versions of Windows so just look a little bit clunky, the

ones that have been around a couple of years just look swishier…and

the ones that are out there you’re not confident that they’re not

going to go bankrupt in the next couple of years…”


Project initiation

Pre-implementation

Implementation

System optimisation

Maintenance

Impact

Evaluation

Establishing a project team, engagement of stakeholders, securing high-level support

ConceptualisationAssessing local requirements, homework (looking at systems and understanding/re-designing processes),

anticipated benefits, drivers and the underlying evidence base

Drafting a business case

Procurement/tendering

System choice

Process/templates, risks, resources, overview of systems/suppliers, site visits, networking

Process, scoring, engaging suppliers

Based on needs and available options, analysis of bidders

Training, piloting, work process mapping, IT requirements (infrastructure, interfacing, software, hardware), continued engagement, configuration and testing, data migration, back-up systems, process management,

implementation strategy and roadmap, champions

Relationship with suppliers, initial support, timelines and transition to BAU

Upgrading, on-going support, dealing with workarounds, continuing development and customisation, change in role of project team

Benefits realisation, investment analysis

Progress reports, lessons learned and sharing of experiences, benchmarking, data quality monitoring, reporting, risk registers, critical

incidence reports and analysis

Functional specification Existing range of suppliers and systems, product specification and functionality

Contracting Process, dividing responsibilities, awarding the contract, contract negotiations

On-going development E.g. Trusts upgrading to another system


Aims of today’s workshop

Facilitate open discussion regarding the development of business cases from the perspective of different stakeholders

Support sharing of experiences and networking


Structure of the workshop

Moderators: Jamie Coleman and Ann Slee

PART 1: Conceptualisation and project initiation

12.30-1.30 Lunch and networking

PART 2: Functional specification and drafting a business case

Group work in breakout sessions followed by feedback to all


Organisation of this workshop

Information and consent

Anonymity assured, recording preferred

Kathrin and Rosemary for logistical questions

Suggestion sheets for anonymous feedback

Evaluation at end of the day

Summary report will be circulated to participants for comments


Next steps

We want your ideas for

Conferences

Workshops

Round table discussions…


Further sources of information and support…

Our website:

www.chs.med.ed.ac.uk/projects/eprescribing

For copies of presentations, events and updates

http://www.chs.med.ed.ac.uk/projects/eprescribing


Date for your diary…

conceptualising and developing a business case for hepma systems round table discussion · 2016. 8....

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