NHS Ayrshire and Arran (NHSAA) was an early adopter of the pharmacy-integrated model for hospital e-prescribing after a trial at Ayr hospital in 1999 demonstrated a rapid and clear reduction in medication errors and improved quality of prescriptions.

At the forefront of e-prescribing

Ayr Hospital worked collaboratively with WellSky to develop the original HEPMA solution to address key clinical requirements around medicines management.

This solution was rolled out across six wards, including admissions, coronary care, orthopedic,
and general medical wards.

“Integration with other NHS systems is easy, it fits into the way we prefer to work rather than the other way round.”
Richard Cottrell, Senior Clinical Pharmacist and HEPMA Pharmacist

The response from users was extremely positive, with the benefits of legibility, reduced errors during prescribing, administration and dispensing, and information being available directly at the point of need all being reported by users.

The ability to share this information in other wards and the pharmacy dispensary further helps to improve the accuracy and rapid access to key information.

The system has now been deployed across both Ayr and Biggart hospitals, including speciality wards such as high dependency, surgical high dependency, long stay and care for the elderly.

Refining the solution, reaping the benefits

The HEPMA solution and Pharmacy Management modules form a single, integrated system, covering all NHSAA hospitals on a single system.

The integration of hospital prescribing and pharmacy services allows end-to-end medicines management processes that handle the complete cycle from prescribing, clinical verification and dispensing, to drug administration by nursing staff.

Benefits of the system for the Health Board include routine use of electronic prescribing data for auditing, customised clinical reporting, delivery of the system via wireless technology and mobile devices.

The hospital’s use of specialised drug trolleys on wards allows the Health Board to push the boundaries of advanced patient care. These ‘smartcarts’ feature a mobile terminal with wireless connectivity, enabling staff to prescribe and administer medicines at the bedside – enabling staff to spend more time with patients, reducing errors and improving the patient experience.

Integration with pharmacy management has also helped minimise the administrative overheads of monitoring and maintaining accurate levels of ward-held drugs.

Another key feature is the integrated clinical decision support capability which provides access to real-time information and alerts.

Clinical staff use this information during the prescribing and administering processes to minimise risks to patients such as drug duplications, allergic reactions and potential side-effects.

In-depth reporting

The System C solution’s reporting functions have been welcomed by staff and improved auditing and clinical data management. Usage reports produced from the HEPMA data are helping to manage appropriate and prudent use of medication throughout the Health Board.

For example, one of the reports allows clinicians to get an immediate overview of patients with prescribed antibiotics and see: how quickly treatment was started; whether any doses were missed; and even the exact time each dose was given.

This also allows the hospitals to maintain detailed records of any restricted antibiotics or combination regimes. Without e-prescribing in place this level of information would simply not be readily available.

“A key benefit of reporting is not just the historical data, but also the real-time information. For example, real-time reports of specific antibiotics or anticoagulants can be produced to enable daily monitoring.”
Richard Cottrell, Senior Clinical Pharmacist and HEPMA Pharmacist

Users can also conduct custom in-depth analyses of the information in the System C HEPMA database, using the system’s reporting tools to extract the information and display the results in a range of easy-to-use formats.

This gives doctors a completely up-to-date picture of the latest information on what is being prescribed and why during their daily rounds.

Historical reporting also enables clinicians to monitor their workload and allows non-medical prescribers to check their prescribing for any given day.

“HEPMA also contributes to improved patient safety by mandating elements of process adherence, such as allergy recording, so that other members of staff are guaranteed to have this information immediately available.”
Richard Cottrell, Senior Clinical Pharmacist and HEPMA Pharmacist

In addition to enabling best-practice, the solution also improves communication and efficiency by producing immediate patient discharge letters, helping to eliminate unnecessary hospital waiting time for patients.

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