What does the future of electronic prescribing look like?

Electronic prescribing and medication administration (ePMA) systems have become common in UK hospitals. However, they often have different workflows and clinical guidelines, causing differences in how ePMA systems are used, which prevents sharing of medicines data across care settings.

At Better Meds event in February in London, Rahul Singal, Chief Pharmacy and Medicines Information Officer at NHS England, shared some strategies that NHS England is adopting to address this:

Interoperable medicines standards must be defined and adopted to achieve safer patient care. To achieve true interoperability, these standards must be available across all care settings.


Adoption of the Electronic Prescription Service (EPS) must be increased across all care settings. EPS is aligned with national interoperability standards and is improving both patient and staff experience.

The NHS has been in the pursuit of digitalising systems in homecare through e-prescribing for medicines. EPS is essentially a prescription message service in charge of sending prescriptions electronically to a dispenser of a patient's choice. Its purpose is to establish a more convenient service, and the scope of this vision encompasses a pain-free process, accurate data and better system intelligence, as highlighted by See Mun Wong, Interim Regional Pharmacy Procurement Specialist at Liverpool University Hospitals NHS Foundation Trust at this year’s Clinical Pharmacy Congress in London.

According to See Mun Wong, the desired outcomes of transforming national prescribing via EPS are:

•    putting patients at the heart – of everything,  
•    focusing on staff experience,  
•    improving system efficiency, and  
•    optimising care and improving safety.

We need to be aware, however, that homecare is a complex area. While EPS is a pipeline of sorts, it does not solve all of the pathway problems of the secondary care, so expectation management is crucial, Nishali Pathel, Clinical Lead in EPS Product Development at NHS England, warned at CPC. Supporting homecare remains a challenge, but one part of the challenge is addressed with Output-Based Specification (OBS): a set of minimum mandatory requirements to simplify hospital work and establish a reference to use for the system suppliers. 

The benefits of homecare e-prescribing via EPS include increased:  

•    patient experience,
•    access to medicine,
•    prescribing practice and efficiency, 
•    prescription and status visibility,
•    security of prescription transmission,
•    service efficiency,

and reduced:

•    prescription processing delays, 
•    patient safety risks,  
•    patient confidentiality breaches, 
•    risk of prescription loss, 
•    paper,  
•    risk of prescription fraud. 

A world of opportunity remains for digitalised homecare, from virtual wards and hospitals at home to remote consultations and reducing patients’ length of stay. EPS will help Trusts to leverage digital strategies and solve the prescribing first and then the dispensing challenge.

Some complexities and questions remain regarding patient safety. Before committing to this new model of care, communication from community pharmacy back to secondary care prescriber should be resolved. However, Rahul Singal thinks that „the use case for EPS is strongest in community service – I think community and mental health services will be the trailblazers on this.“


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