eMAS Walkthrough

1. eMAS Walkthrough Registration, registration updates and consultation

2. Core Infrastructure Components

3. Pharmacy Prior to ePharmacy the systems and communications infrastructure consisted of the computer system in the pharmacy and the payment processing and associated systems at practitioner services with communication via paper prescription forms and reports. Practitioner Services CHI Payment processing systems

4. Pharmacy N3 network Community pharmacies need to have a connection to the N3 network. This is achieved as an independent connection or as a ‘corporate’ connection. Practitioner Services CHI Payment processing systems

5. Pharmacy N3 network The ePharmacy message store provides a secure, resilient, single point of contact for all messaging for MAS and all future ePharmacy applications. Practitioner Services CHI ePharmacy Message Store Payment processing systems

6. Pharmacy N3 network Remunerating pharmacies on a capitation basis requires a central patient registration system (PRS) to support this. The system contains the rules for patient registration and integrates with the payment systems and the CHI system to provide CHI numbers to pharmacies. Practitioner Services Patient Registration System CHI ePharmacy Message Store Payment processing systems

7. Pharmacy N3 network MAS The Minor Ailment Service requires new ways of working in the pharmacy. Pharmacy systems have developed support for the new service as well as developing the messaging support required to participate in ePharmacy. Practitioner Services Patient Registration System CHI ePharmacy Message Store Payment processing systems

8. Pharmacy N3 network Electronic messages MAS Electronic messages are used in addition to paper CP2 forms. The messages allow for ‘real time’ responses to registration requests and the delivery of CHI numbers. The electronic data is used in place of the paper forms in payment processing to vastly improve data capture. Practitioner Services Patient Registration System CHI ePharmacy Message Store Payment processing systems

9. Registration

10. Registration Process • Individual’s data • Name • Address • Date of birth • Exemption status • Enter data on PMR system • Central Patient Registration System (CPRS) via N3 • Registration confirmed with CHI number

11. Pharmacy Practitioner Services Patient Registration System CHI Person presents and wants to register for MAS. ePharmacy Message Store

12. Pharmacy Practitioner Services Patient Registration System CHI Information is captured and added to the pharmacy system (or an existing record is updated). ePharmacy Message Store

13. Pharmacy Practitioner Services Patient Registration System CHI CP2 form for registration is printed and person signs to confirm their exemption status. The person can leave at this point. ePharmacy Message Store

14. Patient details are automatically added. Pharmacy details are automatically added. • If the CHI is not known at the time of registration the DoB is placed in CHI field and 4 digits are added at the end. • ‘0008’ shows a patient born in the 19th Century • ‘0009’ shows a patient born in the 20th Century • ‘0000’ shows a patient born in the 21st Century CP2 type and sex of patient is automatically printed. • Further automatic additions include: • Date • PS Contractor Code • RPSGB Reg Number A unique barcode is created on the CP2 registration form. The barcode number is also part of the registration message sent from the pharmacy PMR. A registration barcode number begins withthe lettersRE.

15. Pharmacy Practitioner Services Registration request Patient Registration System CHI … and an electronic message is sent. ePharmacy Message Store

16. Pharmacy Practitioner Services Registration request Patient Registration System CHI Registration message The message is directed via the ePharmacy store to the Patient Registration System (PRS). ePharmacy Message Store

17. Pharmacy Practitioner Services Registration request Patient Registration System CHI Registration message The PRS applies the registration rules and locates the person on CHI then records the person as registered at the pharmacy. ePharmacy Message Store

18. Pharmacy Practitioner Services Registration request Patient Registration System CHI Registration message Registration Response (with CHI) PRS then replies with the registration status and CHI number and the information is automatically updated on the pharmacy system. Registration is complete. ePharmacy Message Store þ Registration details updated

19. Pharmacy Practitioner Services Registration request Patient Registration System CHI Registration message Image Store Registration Response (with CHI) Later… CP2 registration forms are submitted by the normal route to Practitioner Services where they are imaged and stored. (The registration is already complete). ePharmacy Message Store

20. ‘deferred’ registration

21. Pharmacy Practitioner Services Registration request Patient Registration System CHI Registration message Recap: Patient presents to register. The patient’s details are added or updated on the pharmacy system. A CP2 for registration is printed and a registration message is sent. The PRS responds confirming registration and returning CHI number. The patient record is automatically updated. ePharmacy Message Store þ Registration details updated

22. Pharmacy Practitioner Services Registration request Patient Registration System CHI Registration message What if a registration response is not received? There are a number of reasons why this might happen… ePharmacy Message Store

23. Pharmacy Practitioner Services Registration request Patient Registration System CHI Registration message The patient may not be uniquely identified on CHI. (Perhaps details match a number of entries, e.g. twins or perhaps the patient has only recently moved to Scotland). ý ePharmacy Message Store

24. Pharmacy Practitioner Services Registration request Patient Registration System CHI Registration message The patient registration service may be unavailable or undergoing routine maintenance. ePharmacy Message Store ý

25. Pharmacy Practitioner Services Registration request Patient Registration System CHI Registration message The ePharmacy message store may be undergoing routine maintenance or the connectivity from the pharmacy may be temporarily unavailable. ePharmacy Message Store ý

26. Pharmacy Practitioner Services Registration request Patient Registration System CHI Registration message Important. If any of these events occur there is no interruption to MAS provision. The patient is recorded as ‘pending’ registration and a MAS consultation CAN be performed. The registration request will be completed. ý ePharmacy Message Store ý ý þ ‘Pending’ registration – OK to proceed

27. Pharmacy Practitioner Services Registration request Patient Registration System CHI Registration message There is resilience built in at each stage. A process on the pharmacy system will attempt the resend the message taking care of even prolonged communication interruptions. ý ePharmacy Message Store ý ý Q

28. Pharmacy Practitioner Services Registration request Patient Registration System CHI Registration message There is resilience built in at each stage. If PRS cannot be contacted in ‘real time’ then the message will be delivered in ‘batch’ for processing overnight. ý ePharmacy Message Store ý ¾

29. Pharmacy Practitioner Services Registration request Patient Registration System CHI Registration message There is resilience built in at each stage. If a unique match cannot be found PRS operations team can manually find the correct patient. ý ePharmacy Message Store € PRS Operations

30. Pharmacy Practitioner Services Patient Registration System CHI The registration response is delivered via a registration update once completed. ePharmacy Message Store

31. Pharmacy Practitioner Services Patient Registration System CHI Registration updates The patient registration delivers registration updates to the ePharmacy message store. (These include completed deferred registrations and changes notified from CHI). ePharmacy Message Store

32. Pharmacy Practitioner Services Registration update request Patient Registration System CHI Registration updates Registration update response The pharmacy request registration updates (suggest daily) and these are delivered to the pharmacy system where the patient records are updated. ePharmacy Message Store þ Registration details updated

33. Pharmacy Practitioner Services Registration update request Patient Registration System CHI Registration updates Registration Updates ePharmacy Message Store ¾ Overnight Process þ Registration details updated • Deferred registration results • Withdrawal • Death • Care home • Registration at another pharmacy • Lapsing pharmacy • Roll-on

34. Consultation

35. Care Provision • Person presents at their pharmacy • Pharmacist checks their eligibility • Pharmacist consults with person • Pharmacist offers • Treatment and advice • Advice only • Referral • Associated healthy lifestyle advice

36. Pharmacy Person presents for a MAS consultation. Practitioner Services Payment Processing ePharmacy Message Store Image Store

37. Pharmacy The person’s registration status is checked on the pharmacy system and eligibility re-confirmed. Practitioner Services Payment Processing ePharmacy Message Store þ Image Store

38. Pharmacy The person and pharmacist consult deciding on an outcome. Practitioner Services Payment Processing ePharmacy Message Store þ Image Store • Treatment • Advice • Referral

39. Pharmacy Information is recorded on the pharmacy system to support the dispensing and labelling process (if treatment is required). Practitioner Services Payment Processing ePharmacy Message Store Labels þ Image Store • Treatment • Advice • Referral

40. Pharmacy A CP2 form is printed (the information is gathered as a by product of the labelling process). The pharmacist signs the CP2 form and the person signs to confirm their exemption status. The person can leave. Practitioner Services Payment Processing ePharmacy Message Store Labels Image Store

41. If the CHI is not returned following a registration the consultation can still go ahead. The CP2 consultation form will be printed as normal but the CHI will be missing. The patient signs the CP2 and can leave the pharmacy. Before you can send the CP2 consultation form to Practitioner Services, you must wait until you receive the CHI in a message and hand write it onto the form. A unique bar code is created on the CP2 consultation form. The barcode number is also part of the consultation message sent from the pharmacy PMR. A consultation barcode number begins with the letters CE. Endorsing information is added to the CP2. A maximum of 2 items may be dispensed during 1 eMAS consultation. If you have given advice or referred a patient to their GP, this will be indicated on the CP2 consultation form.

42. Pharmacy Consultation Claim Claim Acknowledgement … and an electronic claim message is sent and receipt is confirmed by the ePharmacy store. (Note: the claim has not yet been verified and passed for payment). Consultation is complete. Practitioner Services Payment Processing ePharmacy Message Store Labels Image Store

43. Pharmacy Consultation Claim Claim Acknowledgement Later… The CP2 forms are submitted by the normal route to Practitioner Services. Practitioner Services Payment Processing ePharmacy Message Store Labels Image Store

44. Pharmacy Consultation Claim Read barcode & get message Claim Acknowledgement The barcode on the form is read and the electronic message is retrieved. The electronic message information is used in place of the information that would otherwise be scanned from the CP2 form. Note: handwritten information is not used! Practitioner Services Payment Processing ePharmacy Message Store Labels Image Store

45. Pharmacy Consultation Claim Read barcode & get message Claim Acknowledgement The CP2 forms are imaged and stored. Practitioner Services Payment Processing ePharmacy Message Store Labels Image Store

46. Questions?