When the NHS started a project to define the standards for integration between ePrescribing and pharmacy systems from different vendors and thus took an enormous step towards meds interoperability, our Better Meds team was invited to join the initiative. As the first go-live is expected soon, we talked to Mitja Lapajne, Better Meds Technical Lead. The main topics were the latest updates on the project but also the main outcomes for healthcare providers and clinical teams in the UK when the project is live.
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Mitja, what do you think has triggered this project?
I could say that the project is the result of the NHS long-term strategy towards interoperability. But I will give a much simpler answer – it is all about patient safety and clinical teams. Let me explain – in hospitals, in most cases, medications are ordered in the ePrescribing system and then manually transcribed into the pharmacy system. This transcribing can cause a lot of errors and is also time-consuming. But if both systems have structured data and use the same coding, this could be done automatically and thus more safely.
The NHS detected such manual transcription as a problem, and they started this initiative to define a standard for integration between ePrescribing and pharmacy systems. Similar integrations are also expected for transferring medication lists between two hospitals or between a hospital and GP. This will help clinicians to see what medications a patient is taking, and when and why were they changed. They will be able to make more informed decisions.
Which standards will be used to exchange data?
The FHIR STU3 standard is used to exchange data, which means that medication, dose, timing, route and other details are structured and coded. There is two-way communication between the ePrescribing system and the pharmacy system. Medication request and Medication Dispense FHIR resources are used to exchange data.
But, we have different vendors with different standards? What are the main problems? Can a standard cover something as complex as ePrescribing?
The problem with integration standards is that they can be interpreted differently by different vendors. To make such integration successful, all the details need to be very strictly defined. That is why an INTEROPen CareConnect FHIR profile with a more precise definition was created. Defining the exact structure for all different types of prescriptions was also a significant step.
What will, in practice, be the main benefits for healthcare providers?
Well, the main benefit for clinical teams will be ordering of medications from the pharmacy with a single click. They will also be able to see when the medication is dispensed or if the supply request is rejected. Data will be automatically transferred between systems, which should reduce transcribing errors, save time, and establish #better communication between healthcare professionals. All of these things will lead to increased patient safety.
How is Better involved with this, and where and when is it first going live?
For us, as an ePrescribing solution provider, it is essential to be part of the pilot project from the very beginning. All the more so because Somerset NHS Foundation Trust, which went live a few weeks ago with our Better Meds, will be the first pilot site in the UK. Right now, we are in the final stages of developing the integration between our ePrescribing system Better Meds and another vendor's pharmacy system. This integration will use the specification defined by the NHS, and we will be able to integrate with any pharmacy system when they become compliant with this standard.
Is this one of the indicators showing that in the NHS, the digital transformation of healthcare is going in the right direction and is thus future-proof?
I think that with the interoperability efforts, things are going in the right direction; the NHS has an excellent team working on the med interoperability project, and the progress is fast. I am happy we are part of the project and have an opportunity to help define these guidelines. We strongly believe this very technical solution can have a significant impact on patient safety.