Core Services
Background
In 2001-2002, a pilot project was established within NHS Ayrshire & Arran to develop a system to provide the necessary functionality for the Electronic Transfer of Prescriptions (ETP). Stage I of the pilot was completed in the latter part of 2002-03 and provided valuable lessons to inform a wider Stage II roll out of the pilot. The Right Medicine; a strategy for pharmaceutical care in Scotland was published in February 2002 and resulted in a broadening of the pilot’s objectives to include the development of eApplications that would support the future delivery of the new Community Pharmacy Contract and improve communications across the healthcare team. To reflect the extended remit, the initiative as a whole was re-branded as the ePharmacy Programme.
Since then there have been further policy and service developments that have resulted in changes to the ePharmacy Programme, as an integral part of the wider NHS eHealth programme.
The Generic Architecture & Infrastructure
At the heart of the ePharmacy infrastructure is an ePharmacy Message Store (ePMS), which is used as a gateway and store for encrypted messages sent between GP systems, community pharmacy systems and National Services Scotland (NSS). ePMS supports all current e-service developments. It has been designed on the basis that further system developments or changes can be accommodated where required. The standards and architecture used for this and all other system developments and interfaces are developed in conjunction with National and European guidelines and within the overall direction of the National IM&T strategy so, for example, the data collected in ePharmacy transactions can be a contributor to the Electronic Health Record (EHR) in the future.
All community pharmacies have been connected to N3 as part of the infrastructure support programme and this has also allowed access to NHSmail. Another infrastructure requirement was to standardise on the drug dictionary to enable a common language between GP, pharmacy systems and NSS until such time as all systems use the UK agreed drug dictionary, the Dictionary for Medicines & Devices (dm+d). Overall, this allows for a more efficient system for processing ETP transactions, and for the development of automating the payment process for reimbursing pharmacists’ drugs costs.
The current payment process for both remuneration (fees and allowances) and reimbursement (of drug costs) is already automated to a degree whereby dispensed prescriptions are scanned by an optical reader and processed accordingly. The advent of ETP and drug dictionary mapping allows this to be further automated through an ePay Programme which will improve the efficiency of the current payment system by removing the reliance on paper processing. This will also provide quicker and richer sources of data for the NHS.
A central Patient Registration System (PRS) has been developed in order to allow community pharmacists to register patients for both the Minor Ailment Service (MAS) and the Chronic Medication Service (CMS). This uses the Community Health Index (CHI) as the unique patient identifier during the registration process.
Service development has also resulted in changes for both the community pharmacy and GP IT systems in terms of ePharmacy functionality. This covers the distribution of digital certificates to authenticate valid message sources (i.e. GP practices and community pharmacies) and system application developments in terms of specific software enhancements. A key action in the ePharmacy programme has been the early engagement of the system suppliers to inform them fully of the strategic and operational direction of the programme and to secure their commitment to configuring their systems accordingly. This initiative is going well with all suppliers supportive to the ePharmacy development process.
A centrally funded IM&T Facilitation Programme for community pharmacy provides a community pharmacy IM&T facilitator network to support the delivery of the ePharmacy Programme. Contact details for your local facilitator/s can be found by clicking on the relevant NHS board.
In addition the ePharmacy Helpdesk is there to deal with calls relating to the operation of the MAS/ePharmacy system and the patient registration support team can intervene if and when required to support the registration process.
Scope
The ePharmacy Programme is a national programme working with:
- All GP IT system suppliers representing in Scotland;
- All CP IT system suppliers representing in Scotland;
- Practitioner Services;
- Information Services Division (ISD);
- NHS Counter Fraud Services;
- eHealth Programme.
Once the solutions supporting the services are rolled out on a national basis, ePharmacy will continue to support the services on an ongoing basis in a business as usual arrangement.
The design of the ePharmacy infrastructure and message protocols assumes changes that will be likely from technology and business led developments. For example digital signatures, is a potential development for the future. The infrastructure delivered by this project is designed to be a user/contributor of any forthcoming changes.
The sections on the navigation bar describe the specific ePharmacy functionality for each of the core contract services and the ePay Programme.