ePharmacy Programme: The Chronic Medication Service

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ePharmacy ProgrammeThe Chronic Medication
Service

• Alison Strath
• Principal Pharmaceutical Officer, Scottish
  Government
• David Green
• ePharmacy Programme Manager

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Objectives

• To provide an overview of the ePharmacy Programme
  
• To describe the GP elements of the Chronic
  Medication Service (CMS)
• To share next steps and timelines for
  implementation

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ePharmacy Programme Overview
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ePharmacy Programme

• Minor Ailment Service (eMAS)
• Live June 2006
• Acute Medication Service (eAMS)
• Live July 2009
• Chronic Medication Service (eCMS)
• In progress

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Programme Organisation
Ministerial/National IMT eHealth strategy
ePharmacy Programme BoardScottish Government,
National Services Scotland, ePharmacy Programme
Manager (plus other key stakeholders)
Other Programmes and projects. e.g. ECS, GPIT
ePharmacy Advisory Support GroupsNHS
Boards, Clinicians, CPS,SGPC, SCIMP
ePharmacy Programme Implementation team
ePharmacy MessageStore interfaces
PSD ePharmacyProgramme
ISD DataWarehouse
GP IT system suppliers x 4
CP IT system suppliers x 6
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Core Infrastructure
CHI
GP (1000)
NSS PSD
Information Services Division
Patient Registration Service
A
ePharmacy Message Store
Elec msgs via N3 network
Payment process
Pharmacy (1200)
ePay rules engine
A
Forms sent to PSD
Scanning and message processing
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Delivered to date

• Minor Ailment Service
• Live in June 2006
• Patients registered electronically
• Prescriptions generated electronically
• Reimbursement claims made electronically
• Acute Medication Service
• Live in July 2009
• 98 of all GP practices and community pharmacies
  enabled
• 900,000 prescriptions sent electronically every
  week (95 of all prescriptions)
• 92 of prescriptions received in pharmacies are
  processed and claimed electronically
• First full end to end UK ETP solution

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The GP elements of the Chronic Medication Service
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The Chronic Medication Service

• Description
• A system of personalised pharmaceutical care to
  patients with long term medical conditions
• Purpose
• To ensure patients obtain optimal therapeutic
  benefit from their medicines and minimise any
  predictable undesirable effects

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GP elements of CMS

• Patient registration
• Patient registration notification
• Shared Care
• Serial prescribing
• Feedback
• Dispensing information
• End of Care Treatment Summary

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Patient registration

• Process
• A patient can only register with one pharmacy
• Registration is via a central Patient
  Registration System (PRS) using the CHI database
• It is underpinned by explicit patient consent
• GP practice receives an electronic registration
  notification message
• Eligibility criteria
• Patient must be registered with a Scottish GP
  practice
• Patient must have a long term condition
• Withdrawal
• Patient can withdraw or be withdrawn at any time

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Shared care serial prescribing

• Initial eligibility criteria
• Age or medical exemption categories
• The patients GP
• decides on their suitability for a serial
  prescription
• selects the appropriate dispensing intervals
• The patients pharmacist
• dispenses the prescription in defined instalments

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Feedback

• GP

• Patient registration notification message
• Dispensing information
• End of Care Treatment Summary
• summary of all the dispensing feedback
• any appropriate additional information
• serial prescription renewal request (optional)
• Received queued electronically in the GP IT
  system

ePharmacy Message Store
Elec msgs via N3 network
CP
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Testing prior to roll outearly adopter sites

• SEF business reviews
• Select one NHS board
• Identify early adopter sites
• GP practices and community pharmacies
• 8 week consolidated end to end testing
• Registration
• Serial prescription
• End of care treatment summary
• Extend to 24 weeks
• Develop toolkit for implementation

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Progress to date

• To date 5 GP practices and 6 community pharmacies
  involved
• This month another 3 GP practices and 3 community
  pharmacies
• Continue the EA testing into next year
• Identify lessons learnt and include in any
  training and communication materials
• Produce an implementation toolkit including an
  implementation support pack for GPs, CPs
• Commence as a full service in April 2010
• Continue to evolve, learn, improve.

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Come and see for yourselves at the AOA stand

• Demo
• Patient registration, serial prescribing
  dispensing and feedback

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Questions..