The Isle of Wight NHS Trust together with System C have successfully achieved a 100% paperless pharmacy service that reaches across wards, locations and care settings to improve efficiency, patient care and auditability in one of the UK’s most varied and technically advanced Trusts.

Moving to paperless

The Isle of Wight initially implemented their Pharmacy Management module in 1988.

In October 2010, the Trust approved funding to implement System C Electronic Prescribing and Medicines Administration (EPMA) and began an 18 month modernisation programme to migrate to a paperless medicines management environment.

Implementation of the System C system has meant that prescribing, administering and clinical verification of prescriptions is done electronically at all locations and pharmacy dispensing services are 100% paperless too.

Stock is monitored and dispensed automatically via bulk, dispensary and wardbased robots and nurses’ clinical notes and administrations are captured digitally to achieve an end-to-end solution.

A complex landscape

As a unique combined Trust that includes Ambulance, Acute, Community, Mental Health and Prisons, the System C EPMA record is continuous and seamless as patients pass between care settings. Although HM Prisons doesn’t use System C EPMA, the full dispensing history is available on admission, and any changes are immediately clear on discharge to the prison.

“The functionality and flexibility of the System C system enabled the IoW Trust to integrate inpatient prescribing across a number of wards and specialist environments, including Mental Health, Emergency Department and Pre-operative Assessment Units as well as the operating theatres.”
Gill Honeywell Former IoW Chief Pharmacist

In addition to covering such a broad range of settings, three different types of automation (each with stock control interfaces to the pharmacy management system) have been put in place to accelerate dispensing processes.

The Trust are also using ServeRx’s ward-based automation system which enables them to dispense and re-order stock for the Emergency Department and their integrated GP out-of-hours service with little human intervention.

End-to-end services

The drive to roll out to such a wide range of care settings means that the Trust is reaping ever greater benefits from the system such as comprehensive and centralised reporting, transferring patients between settings with ease, and medicines reconciliation between primary and secondary care.

“The benefits of this approach include a more seamless care delivery process and improved continuation of care post-discharge to reduce hospital admissions.”
Gill Honeywell Former IoW Chief Pharmacist

A cross-sector reablement service allows the IoW to e-mail the patients’ TTOs to a secure central mailbox, and a community pharmacist continues the care with accurate and up-to-date information.

The response from both nurses and other users has been positive. Improved patient chart legibility coupled with ease of access to information – even from remote locations – not only encourages good practice but allows for shorter, more efficient ward rounds and improved patient care.

Realising measurable benefit

Historically, paper drug-charts have been a primary source of information for clinicians and could be accessed by the various staff involved, depending on the care scenario. Replacing patient paper charts with a software system is neither easy nor a perfect solution, but the Trust believes the need to improve clinical documentation and make better use of patient data for better outcomes and patient care far outweighs the resistance to change.

“Reduced wastage of medicines and the ability to track missed doses has resulted in cost savings through better care quality and safety. Workflows have dramatically improved and reports of saved time point to even more benefits from working within an electronic environment.”
Gill Honeywell Former IoW Chief Pharmacist

Enabling varied clinical teams to easily access accurate patient information and results demonstrate that the benefits are far reaching and not limited to the pharmacy alone; the benefits are truly Trust-wide.

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