This trust is one of several hospitals nationally who have
developed and implemented a model to prioritise patients, as an enabler in
providing targeted seven day clinical pharmacy services. Electronic prescribing
systems have the added value of providing intelligence of prescribing activity
that occurs during the patient pathway in hospitals
. (The full case study can be viewed on p.20 of NHS
England: Transformation of seven day clinical pharmacy services in acute
The clinical informatics team at Newcastle Hospitals was created when the trust introduced an electronic patient record (EPR.) The electronic prescribing (ePx) component of the system was implemented by the pharmacy department with the assistance of a multi-disciplinary project team. Over the last decade the system has been continually developed and is now digitally mature.
Key to their ongoing informatics development is the Trust’s investment in a permanent pharmacy informatics team. The pharmacist-managed team of pharmacy technicians, led the initial implementation being involved in process mapping, process design, system build and user engagement. They also designed the testing, training and governance processes to ensure safe successful implementation and compliance with information standards for clinical systems.
The team have subsequently developed the system in close collaboration with the Trusts IT services. They have provided leadership on several system upgrades e.g. JAC upgrades and creation of a network version of the Trust’s chemotherapy ePx system. The team have also led on the uptake of new EPR functions. An example of this being the development of clinical pharmacy prioritisation tools, which provide a supplement to traditional decision support models. The skills gained during this have benefitted medicines optimisation and wider applications of the EPR such as laboratory services.
Experience, through continuity of the team, has been an important factor in ongoing improvement. This has been developed through the Trust supporting the pharmacy informatics team to undertake informatics qualification e.g. Informatics degrees, system architecture courses. With a wider understanding of the technical and operational aspects of developing and maintaining an EPR the team has improved in troubleshooting , rule creation, report writing, interface development an example utilising all of these being the development of an EPR-generated and automated community pharmacy referral process (Clinical Handover).
Another key to success is ensuring the pharmacy informatics team are represented on key Trust groups and committees. Representation at these has been essential to ensure that informatics is developed according to Trust priorities and to ensure that informatics and its opportunities are embedded into new Trust developments with the engagement of key stakeholders.
Finally the team are heavily involved in national collaborative forums for informatics. This has greatly enhanced their own knowledge but also allowed them to share their own experiences as informatics centres drive to share good practice.