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E-Discharge with formulary control

E-Discharge with formulary control. David Rose. Clinical Design Lead. Introduction. Good Afternoon! Not Rhian Rice Technical design architect e-Discharge e-Formulary (drug file) Importance of this Budget control – least important aspect David Rose Clinical Design Lead (NWIS)

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E-Discharge with formulary control

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  1. E-Discharge with formulary control David Rose Clinical Design Lead

  2. Introduction • Good Afternoon! • Not Rhian Rice • Technical design architect • e-Discharge • e-Formulary (drug file) • Importance of this • Budget control – least important aspect • David Rose • Clinical Design Lead (NWIS) • Senior Pharmacist – Lead IM&T ABMU HB • Overview of what’s going on in Wales

  3. Why Me • Implemented an e-discharge system in 800 beds 6 years ago • At least 80% of Pts have a completed discharge summary within 48hrs • NWIS invited me to help out with design of WCP • E-discharge & medicines management tool • involved with the clinical design • UCD sessions across Wales • Worked closely with the developers / clinicians • Designed the pharmacy elements of WCP • 3 yr process

  4. Background • Different in Wales • No CfH • NWIS • No money! • Limited resources / funding from Welsh Government • Use it wisely! • Enter the Welsh Clinical Portal

  5. Clinical Information Flow Out of hours Individual Health Record Welsh Clinical Portal Welsh Clinical Communications Gateway GP Systems Integration on one platform • Existing Hospital and community systems • PAS – administration • RADIS2 – radiology system • CANISC • Pharmacy • TELPATH – pathology system • PACS - radiology image store New information Services Pathology ordering Radiology ordering PACS Sharing ( GE ) Laboratory Information M.S. (Intersystems) Creation and viewing of letters, clinical notes, discharges My Health On Line

  6. Welsh Clinical Portal • One stop shop for clinicians • PAS • Biochemistry • Radiology • Information sharing • Medication • Not e-Prescribing tool

  7. What about Pharmacy? • Information retrieval • Drug reconciliation • e-discharge • Supply of medication from ward level • One stop dispensing • Patient counseling / production of compliance aids for pts • Information entered ONCE only • Re-used

  8. Audience Participation • Process map patient pharmacy journey • How many times does a list of drugs get transcribed? • 4,5,6,7 maybe more depending on your systems • Huge opportunity for error! • 5 % at each transcription

  9. Where do you start? • Looked at existing systems across Wales and England • Commercial offerings • Didn't fit the model that we wanted  • We couldn't afford to adapt them • There is NO standard drug file!!!! • Complex beast….. • Previous speakers have eluded to this • VTM, AMD, VMP • Large no of sites in Wales use a legacy pharmacy system • EDS • Drug files are very different • Decided to build our own

  10. If you build it they will come!

  11. The Issues • We needed a common formulary • Look up tool • Information resource • Most sites use EDS • JAC: 1 site • Ascribe: 1 site • Massive differences between files • Worked with FDBE to map the files • Created a common file • Linked it to dm&d codes

  12. The Solution...... • Medusa • Purchased UCHL “Inform” product • 2009 • Used dm&d codes • Mapped this to every item in Wales • Allows us to share info with GP systems • Community pharmacy • WCCG

  13. 2011 • Each site has it's own version of the master formulary • Locally and nationally maintained

  14. MASTER FORMULARY SITE 1 SITE 2 SITE 3 WELSH CLINICAL PORTAL SITE SPECIFIC LOGIN

  15. Benefits • Guides selection for data input • Reduces selection options • eg: Paracetamol • 22 lines • Hundred + products • Provides point-of-care information • Links to e-BNF, SPC and IV guide

  16. Lets have a look!

  17. So What! • Formulary now in operation • Medicines management system built around this • This in turn is built around the patient management software (WCP) • Developed and agreed a common dose syntax across Wales • ShareD this with the medical schools and SOP undergraduates • Iterative development • About to pilot across hospitals in Cardiff & Vale Health Board

  18. Summary • We are trying different things • We hope that we are moving in the right direction • Trying to link everything together • This is NOT an e-Prescribing system

  19. Questions?

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