A first-of-type integration between an NHS health trust’s EPR and its pharmacy stock control system is improving patient safety, simplifying and speeding up the turnaround of medications and reducing administrative burdens to create more time for clinical interventions.
The interface was created by IT specialists from The Health Informatics Service (THIS) for the two hospitals run by its host trust, the Calderdale and Huddersfield NHS Foundation Trust (CHFT).
The aim of the project is to digitise and streamline the entire process of nurses requesting and pharmacy supplying medication, in a way which would enhance patient safety at CHFT’s two hospitals in West Yorkshire,
Huddersfield Royal Infirmary, in Huddersfield, and Calderdale Royal Hospital, in Halifax.
THIS collaborated with two suppliers to create a link between CHFT’s Electronic Patient Record (EPR), hosted by Cerner (now Oracle) Millennium, and its pharmacy dispensing system, hosted on EMIS.
Shirley Haywood, THIS’ Digital Health Programme Manager, says:
“This is a pioneering, first-of-type solution for an Oracle NHS Trust that will pave the way for others to develop and implement similar solutions that improve patient safety and maximise efficiency.”
By directly transferring the medication data from system to the other, it minimises the risk of human error by avoiding manual transcription.
It also ensures adherence to the ‘five rights’ of medication supply – the right patient obtaining the right medication, in the right strength, frequency and form with clear directions for administration on the label.
Previously, nurses typed their requests for medications into one system for the information to be manually copied into the other.
This was done by a medicines management technician, or pharmacist, and needed a second check by a colleague to ensure accuracy.
Prior to the project, a sample of 162 medications requests showed errors in 12 (7.5 per cent) of the rekeyed ones. The target post-project is to have fewer than 1.5 per cent errors.
In the context of 180,000 meds requests per annum via this new process, only three incidents have been logged where the interface proved to be a factor.
Saving time to concentrate on patient care
The old process used to take a pharmacist roughly five hours per day and required them to have a quiet and uninterrupted workspace.
The interface now means medication requests appear along with the patient details, in a list in EMIS, ready for dispensing, removing the manual process completely.
The saving in year one is estimated at 440 hours of pharmacists’ time, equal to 59 days (assuming a working day of 7.5 hours), creating a saving over 10 years of 4,400hours or 590 days.
The time released will allow pharmacists to concentrate on delivering impactful clinical input to patient care, while patients will benefit from extra time for nurses to deliver compassionate care, and by having faster access to medications with a reduced risk of transcription errors.
Katherine Cullen, CHFT’s Deputy Clinical Director of Pharmacy, says:
“The integrated electronic ordering process has revolutionised the way nurses order medication and the pharmacy clinical check and supply process.
“It saves time, is safer and frees up clinical time that was spent on essentially an admin task, for pharmacy and nurses to care for our patients.”
The trust’s Medication Safety Officer, Anita Hill says:
“We are already seeing staff able to focus on interventions more proactively than previously as the time to clinical check and supply medications is reduced.”
Staff on the wards have taken to CHFT’s social media channels to voice satisfaction too. One nurse says:
“This has made a huge difference. The new process is so quick and easy. Fantastic job to all involved in implementing the change.”
A ward-based pharmacy technician adds:
“The nurses on the ward are already loving this! Straightforward and so much easier.” And a member of the resus team posts: “It’s a complete game changer! Absolutely brilliant.”
Placing THIS and CHFT at the vanguard of digitisation
CHFT remains the only Oracle (formerly Cerner) NHS Trust to have implemented an interface between its EPR and the EMIS pharmacy stock control system in this way.
“The new interoperability is the culmination of three meetings a week for several months with representatives from Cerner and EMIS, representatives from CHFT, and our internal integration specialist, project manager and me.
“We sought advice from pharmacy colleagues throughout the process and we led training sessions for them, including those working directly on the hospital wards and within the two dispensaries.
“We included pharmacists and medicines management technicians, dispensary managers, assistant technical officers and in-house IT training team.
“We involved the Chief Nurse Information Officers and attended senior nurse meetings and boards to keep them updated on developments and provide demonstrations.
“The solution utilises dm+d – which is a national standard – for its medicines interoperability functions, placing THIS and CHFT at the forefront of digital transformation.
“It emphasises and drives forward THIS’ status as leaders in digital healthcare and IT services.”
Get in touch with THIS
As well as working within its host trust, THIS provides digital and IT services to health and care providers across the UK in primary, secondary and third sectors, such as NHS health trusts, GPs, laboratories, hospices and not-for-profit healthcare organisations.