progress on healthcare it developments in wales cheryl way national pharmacy and medicines...
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Progress on Healthcare IT Developments in Wales
Cheryl WayNational Pharmacy and Medicines
Management LeadInforming 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)
1 Assembly
10 Trusts
22LHBs
135Hospitals
15,000Beds
81,000Staff
3,000,000Patients
~£3bnBudget
~2000 GP
Practices
NHS Wales
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
Informing Healthcare - A national programme funded by the Welsh Assembly Government
GP systems (lifelong record)
Welsh Clinical Portal
Individual HealthRecord
e-referra
ls/
discharges
(SCI gateway)
My Health Online
Patient access-- over the internet
Current hospitalsystems
•Radiology IS•Laboratory IMS•Prescribing•Scheduling•Ordering
New hospital/community
systems
Clinician access-- where careis delivered
A Shared View of Care
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-of-hours 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
* Feedback from 3 practices on MHOL pilot 2007-8
Prescription items per person p.a.
% of repeat items
Repeat items per practice (6000 list size)
Repeat prescriptions per practice – 10% take up
Minutes saved per practice (1 min per item)*
Weeks saved p.a.
% FTE saved p.a.
21 75 94500 9450 9450 4.5 9%
Pilot
Link EDS toTranscribing
Medicines strategic approach:Summary
Delivertranscribing
via the portal
E-Prescribing of Chemotherapy
Electronic Medicines Management System
Drug Coding
E-Prescribing Service Improvement Project
Central Hosting of EDS System
Conversion
Development
Drug Code
Mapping
Fact Finding, Specification &Procurement
Implementation
Fact Finding, Specification &Procurement
Implementation
Implementation
Portal Transcribing
Inform Business Case for
E-Prescribing inWales
Transcribing
E-prescribing
Pharmacy
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
Pilot
Link EDS toTranscribing
Medicines strategic approach:Summary
Delivertranscribing
via the portal
E-Prescribing of Chemotherapy
Electronic Medicines Management System
Drug Coding
E-Prescribing Service Improvement Project
Central Hosting of EDS System
Conversion
Development
Drug Code
Mapping
Fact Finding, Specification &Procurement
Implementation
Fact Finding, Specification &Procurement
Implementation
Implementation
Portal Transcribing
Inform Business Case for
E-Prescribing inWales
Transcribing
E-prescribing
Pharmacy
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
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Clinical Check
Medication Stopped on this Admission
Medication Status Reason Date
Bisoprolol 2.5mg tablets: Take ONE tablet TWICE DAILY Stopped Pt bradycardic 29/4/08
Current Medication
Medication Started Status CC SS CI
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
Allopurinol: 300mg tablets : Take ONE DAILY 1/2/98 Continued !
Clarithromycin 250mg tablets:Take ONE tablet TWICE DAILY 19/4/08 Started on admission DR 14 AC
Re-start
Note
Pharmacy Note
Date Drug Note Init
18/04/23 Atorvastatin 40mg tablets: Take ONE at NIGHT Consider stopping whilst patient is taking calrithromycin DR
18/04/23 Allopurinol: 300mg tablets : Take ONE DAILY Patient stated that they have stopped taking this Drug. Please review. AC
Pilot
Link EDS toTranscribing
Medicines strategic approach:Summary
Delivertranscribing
via the portal
E-Prescribing of Chemotherapy
Electronic Medicines Management System
Drug Coding
E-Prescribing Service Improvement Project
Central Hosting of EDS System
Conversion
Development
Drug Code
Mapping
Fact Finding, Specification &Procurement
Implementation
Fact Finding, Specification &Procurement
Implementation
Implementation
Portal Transcribing
Inform Business Case for
E-Prescribing inWales
Transcribing
E-prescribing
Pharmacy
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)