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Choosing the right EPMA system – St. Helens & Knowsley Hospitals focus on patient safety and digital maturity NHS organisations are wrestling with the challenge of raising their digital maturity and implementing transformation and change to benefit patients, clinicians and improve outcomes and efficiency
A central and challenging part of this process in the acute sector is the implementation of ePrescribing and Medicines Administration. Whilst some are still starting this journey others have deployed successfully and now are reaping the benefits of both more advanced functionality and a rich source of data which is being used to help transform Medicines Management and provide further clinical integration and tools for end users to enhance decision support and improve patient safety. Issues around ageing infrastructure, change management and limited resources capable of managing these major projects remains a major obstacle to success. For those who meet these challenges the benefits are considerable. St Helen’s and Knowsley Teaching Hospitals (STHK) recently rolled out JAC’s Electronic Prescribing and Medicines Administration (EPMA) system and describe their selection criteria, the functionality they focused on and the roll out process. Rowan Pritchard Jones, St Helens & Knowsley’s CCIO, said: “Of all our digital projects, e-prescribing is the biggest step forward in patient safety. It reduces errors and ensures the right things get to the right place at the right time.” In April 2017, STHK went live with JAC’s new web-based EPMA system. Purchased under the NHS Safer Hospitals, Safer Wards technology
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funding scheme, EPMA works with STHK’s existing JAC Pharmacy stock control module to deliver end-to-end medicines management and is being interfaced with the trust’s new PAS for order communications, discharge data and a range of other functionality. Digital maturity JAC’s new EPMA is also a strategic step forward in digital maturity. Mike McKenna, the trust’s EPMA Programme Manager, said: “It gives us a whole new interoperability environment to share data for things like A&E discharge, remote treatments for mental health facilities and secure patient records for clinicians on the road.” In choosing JAC, the trust opted for an e-prescribing solution with broad functionality, a specialist-designed set of tools and a large and proven user base. Christine Walters, CIO, added: “Since at the time of the selection process we didn’t have an EPR we were free to choose the market leader.” New web benefits The team also wanted a modern web interface that would give remote users quick and easy access to information. Walters comments: “EPMA’s web technology makes the system easier to deploy, add upgrades and link to other applications as our digital environment evolves. Gone are local software reinstalls;
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now we can add updates at the centre and provide users with access via URLs to save time and ensure everyone is on the same version. For remote users, internet data security is assured with firewalls and VPN access codes into the trust server.” Pritchard Jones adds: “In addition to being more intuitive than many systems, the web interface gives clinicians a much greater degree of agility for mobile use.” The digital transition Currently the JAC EPMA is in use on several key wards including stroke rehabilitation and haematology, with Whiston’s remaining 35 wards and departments due to be live by late 2018. When it came to rolling out the new system, the web interface – designed in response to in-depth studies on how users navigate screens – greatly simplified the training process. Dr Francis Andrews, medical director and the project’s chair, says: “I was able to go from paper to working electronically in 15 minutes. As for the nursing staff, nothing would induce them go back now.” The pharmacists were also quickly won over. Having gone through a one-on-one programme of intensive hands-on training to ensure they understood the functionality of the system and how to use it effectively, it was still a big change from what they were used to. Nevertheless, it did not take long for them to become familiar with EPMA. As Dr Andrews points out, the speed with which the hospital’s cultural and technology barriers were overcome is particularly impressive, considering e-prescribing’s complexity which makes it a difficult environment to change. He said: “To start with there’s a vast array of medicines that have to be entered into the system. Protocols and dose banding can be custom configured by the team building the drug database, so they can be tailored to the individual trust and clinician needs. The system also retains alerts for an individual patient’s drug allergies and sensitivities. Because a single error can be life threatening, this explains why medicines management has one of the lowest tolerances to error: It has to be safe.”