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Delivering Clinical Decision Support to the NHS National Programme for IT

Delivering Clinical Decision Support to the NHS National Programme for IT. Andrew Frangleton Head of Strategic Development. Contents. First DataBank Europe - Overview Multilex Drug Data File Clinical Decision Support Standardising Clinical Terminologies Improving Patient Safety.

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Delivering Clinical Decision Support to the NHS National Programme for IT

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  1. Delivering Clinical Decision Support to the NHS National Programme for IT Andrew Frangleton Head of Strategic Development

  2. Contents • First DataBank Europe - Overview • Multilex Drug Data File • Clinical Decision Support • Standardising Clinical Terminologies • Improving Patient Safety

  3. First DataBank Europe - Overview • History • Commenced at the University of Exeter in the late 1970s • Acquired by First DataBank Inc./Hearst Corporation in 1996 • UK and world-wide market leader in the provision of point-of-care knowledge bases to the healthcare industry • ISO 9001:2000 Quality Management System • Core business is drug knowledge bases and clinical decision support • Known widely as FDB, FDBE & Multilex

  4. National Programme for IT (NPfIT) • NASP - National Application Service Provider • Contract with BT Syntegra for the NHS Care Records Service • Provision of drug information • Clinical Decision Support • LSPs – Local Service Providers • Multilex Drug Data File integrated into: • iSoft & Torex Health • IDX & In Practice Systems

  5. Multilex Drug Data File - Products • Used in live clinical applications for over 20 years • Comprehensive product coverage (50,000+ concepts) • ‘Generic’ medicinal product representations • Branded prescription medicines • OTC medicines • Healthcare appliances • Borderline substances • Diagnostic and monitoring agents

  6. Multilex Drug Data File– Knowledge Base • Clinical content • Clinical Decision Support • Referential information • Internally authored monographs • External links • Read 2 & CTV3 drug and clinical codes • PIP codes & EAN numbers • BNF monographs • SPCs & PILs

  7. Quality • ISO 9001:2000 Quality Management System • Well developed Editorial Policies • Project Management based upon PRINCE 2 • In-house maintenance team of pharmacists and clinical researchers • In-house software & database development teams • Customer Implementation team • Help Desk for technical and clinical queries

  8. Clinical Decision Support - at the point-of-care • Drug-Drug Interactions • Sensitivity/Allergy Checking • Drug Doubling by ingredient • Duplicate Therapy by Action Group • Patient specific clinical checks - filtered by age, sex & condition • Contraindications • Precautions • Prescriber Warnings • Dose Range Check

  9. What do you need to drive good decision support? • Drug concepts • Medical conditions • Allergy/Sensitivity information • Age and sex • Height and weight • Dose checking • Standard clinical terminology & information model

  10. Current PMR Recording Drugs, medical conditions, Sensitivities/Allergies and Dose are currently coded using: • Read 2 • CTV3 • ICD10 • OCPS • Proprietary codes • Locally maintained codes • Free text

  11. PMR Fragmentation • Local records, maintained to local protocols are held in isolated islands of information in: • GP • Out of Hours • Community Pharmacy • Secondary/Tertiary Care

  12. NHS Care Records Service • Based on a single common architecture and terminology • Patient information • Drugs • Devices • Medical Conditions • Standard Dosage Syntax • Standard messaging – HL7

  13. SNOMED CT • The NPfIT has chosen SNOMED CT as the standard terminology for drugs and medical conditions • FDBE is in the process of integrating SNOMED CT into the Multilex Drug Data File knowledge base • Drugs and Appliances • Clinical Conditions - to support clinical decision support

  14. Benefits of Standardisation • Clinical System Interoperability • Single integrated care record • A single terminology solution for coding of Medications • Drugs & medical devices • Conditions • Sensitivities/Allergies • Dose • Creates the patient context to provide better decision support

  15. Improving Patient Safety • NHS Care Record Service • A standard terminology – SNOMED CT • Proven drug knowledge base– Multilex Drug Data File • Used throughout the UK • Used across domains • Provides clinical and product information • Provides clinical decision support at the point-of-care • Provides links to valuable reference materials

  16. Working in Partnership • Map Validation Contract • Consortium comprising FDBE, Adel/Synapse/IMS • Read 2 & CTV3 to dm+d • EMIS to dm+d • SafeScript to Read 2 & CTV3 • Multilex to dm+d • Intellect representative on the dm+d Editorial Board • Review of secondary care harmonisation

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