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ETP + ERDIP = ICRS? Experience of the Evaluation of ETP Pilots. Bob Sugden Centre for Software Reliability University of Newcastle Bob.Sugden@ncl.ac.uk. Rob Wilson Centre for Social and Business Informatics University of Newcastle Rob.Wilson@ncl.ac.uk.
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ETP + ERDIP = ICRS? Experience of the Evaluation of ETP Pilots Bob Sugden Centre for Software ReliabilityUniversity of NewcastleBob.Sugden@ncl.ac.uk Rob Wilson Centre for Social and Business InformaticsUniversity of NewcastleRob.Wilson@ncl.ac.uk The work described here was carried out by the authors together with a consortium led by the Sowerby Centre for Health Informatics at Newcastle, including the School of Pharmacy and Pharmaceutical Sciences (University of Manchester); the Industrial Statistics Research Unit (University of Newcastle) and QinetiQ
ETP - Terminology Electronic Transmission of Prescriptions (ETP) (aka National Prescription Service) will be supported in Phase 2 (2006-8) of the Integrated Care Record Service (ICRS) or NHS Care Records Service (NCRS) (formerly known as the Electronic Health Record) N.B. Use of electronic means to prepare and issue paper prescriptions is widespread in UK general practice
ETP – Context of Pilots ETP was piloted and evaluated in England in 2002 The Department of Health commissioned: • three ETP pilots • in three different health areas • using three different business models • privately financed by private consortia: Flexiscript, Pharmacy2U, and TransScript
ETP – Evaluation Literature Although there is a considerable body of literature on electronic prescribing, few refer to electronic transmission from GP to pharmacy, and none to transmission to a body such as the NHS Prescription Pricing Authority (PPA) Studies from the USA and Denmark suggest that ETP confers benefits for GPs, pharmacists, and patients, making the whole dispensing process less time-consuming
ETP – Context of Evaluation The evaluation was intended to: • explore the socio-technical context • assess the change management issues inherent in introducing ETP to general practices, pharmacies and patients • develop technical standards The evaluation was planned as a formative exercise to run in tandem with the pilots…
Pre-ETP - Current Prescribing Process GPprocess Adminprocess Acute Repeat Patientpresent Patientabsent Check EPR Rx Choice Update EPR Update EPR Query Resolution by GP Print Print Query Handlingby Admin. Signed by GP Signed by GP Issued Issued Dispensed
Post-ETP - Prescribing Process Adminprocess GPprocess GPprocess Acute Repeat Patientpresent Patientabsent Check EPR Rx Choice Update EPR Update EPR Query Resolution by GP [Print] [Print] Query Handlingby Admin. Signed by GP Signed by GP Issued Issued Dispensed
ETP - Evaluation Learning Points • Political imperative to implement (50% ETP target by 2005) – DON’T PANIC! - be realistic about the difficulties, timescale and cost • Numerous stakeholder sensitivities – be clear about the objectives and how they will satisfy the stakeholders • Structure, time, finance, and incentive to learn from evaluation - be prepared to spend time & money learning from & rectifying mistakes • Technology can deliver – but make sure the problem(s) are understood before building solution(s) • And finally - a fruity theory of system evaluation…
Pilots Always Bear Fruit Oh **** its all gone shaped!! Evaluating a …when you thought it was a