Special report: medicines management
Sự phát triển trong quản lí thuốc kỹ thuật số sẽ biến đổi việc chăm sóc bệnh nhân tốt hơn trong tương lai
"Số hóa quản lý thuốc không chỉ cung cấp các lợi ích an toàn. Nó có khả năng hỗ trợ y học chính xác bằng cách xác định bệnh nhân sẽ được điều trị tốt nhất bằng loại thuốc nào hoặc liều lượng cụ thể nào. Sự phát triển trong quản lý thuốc kỹ thuật số sẽ biến đổi việc chăm sóc bệnh nhân tốt hơn trong tương lai."
With national funding pledges to increase the uptake of e-prescribing in hospitals, digital medicines management is occupying a prominent place on the national agenda. But does that mean it can now finally hold a consistent place across NHS activity in local
Digital medicines management seems to be front and
Some might say it’s about time. Although the technology has been around for years, and its benefits well rehearsed – reduced errors, improved patient safety and experience, financial and efficiency savings – uptake has remained gradual. The most recent Digital Health Intelligence clinical digital maturity index (CDMI) report showed 56% of trusts had gone electronic for outpatient prescribing, and 43% had for inpatient prescribing.
So will the reports, reviews, and government investment actually make a difference on the ground? Has the battle for digital medicines management been won?
Agreed benefits – but different priority levels
According to Robert Tysall-Blay, chair of industry body techUK and chief executive of JAC Computer Services Limited, it has – at least to an extent. “I think everybody at national and local level accepts that digital medicines
“But there is still a battle in terms of priorities – where medicines management sits in the bigger agenda of
Advances in primary care
But if digital medicines management has been slow to take off in hospitals, some say it’s a different story in primary care. According to Candice Moore, NHS Digital programme head for
She points to a recent extension of the EPS (electronic prescription service), which means patients seeking care out of hours can have their prescriptions sent electronically to the pharmacy of their choice. “The biggest benefit we’ve seen so far has been for patients contacting NHS 111 – it saves faxing a prescription, and as it’s all being done electronically, saves the patients a lot of time and hassle. We’re working with suppliers in this space, but we’ve already had a lot of positive feedback.”
Moore also cites moves to introduce a digital system to show whether patients are entitled to exemptions from prescription charges – something that should both help to cut down on fraud and help patients who are unsure whether they should be paying for their prescriptions. Work is also underway to allow digital prescribing of controlled drugs.
The big challenge, he says, is in
This is serious because, as he points out, around a fifth of hospital readmissions are due to failures to accurately transfer changes to medication to the GP system. “This isn’t a criticism of GPs or hospitals, but it’s not clear to the GP what has changed. There’s a break in the electronic chain and that’s a safety risk.”
He is optimistic that greater interoperability, party driven by
The potential power of prescribing data
For Richard Ashcroft, programme director for digital medicines with NHS Digital,
Mooney also believes that the area of medicines management is about to get much more exciting as it moves into its next phase. “There’s a growing recognition that medicines management should be part of a broader EPR [electronic patient record]. That’s a much bigger undertaking.” He believes it’s one of the reasons there has been something of a “plateau” in the move to
Getting culture change right
Linda Elverson, business development director with Civica, also believes that there have been “key
She cites a number of essential factors to make the most of digital medicines management, including making sure the solution supports the particular requirements of specific care settings,
She is optimistic about the future. “Whilst we remain at a fairly fundamental stage of adoption, digital medicines management will evolve across
Tysall-Blay makes a similar point. “We’re seeing people looking regionally [at digital medicines management], not just looking trust-wide,” he says. “But at every level, you need top-down and clinical buy-in, effective project management and robust infrastructure for a successful implementation.”
Aaron Jackson, solution director for medicines with Orion Health, also believes efforts to support culture change are crucial to success. He cites the company’s recent roll-out of its medicines management solution in NHS Greater Glasgow and Clyde, which commissions and delivers services for some 1.2 million people. Engagement with users has been key, he says. “The team
“Humungous” patient safety advances
As a clinical
“Medication-related errors cost the NHS nearly £100 million a year in re-admissions, length of stay and litigation –
Clinical decision-support software transforms prescribing in several ways, she says. By giving prescribers evidence-based advice, consistency of care is improved, but so is the ability to
And as she points out: “Medicines are integral to every workflow, whether it’s in hospital, the community, primary care or tertiary care.”
She says barriers to uptake include cost, interoperability issues, and the fact some