1 e-Discharge Summary Mark Pepperrell, Principal Pharmacist Nilesh Patel, eRecords Project Analyst

2 Technology Partner Application provider –Our thanks to Ascribe Ltd –

3 Introduction SUHT local hospital care –500,000 people Regional Services ~3 million –Neurosciences –Cardiac –Children’s Intensive Care

4 Introduction Pharmacy Service –250 staff –3 dispensaries (2 sites) –35-40,000 items/month Clinical pharmacy service –Specialist pharmacists –Ward rounds

5 Introduction Discharge summary Carbonized A4 form –Illegible, unclear –GP transfer via post or patient –Pharmacy unaware completed Local initiatives New standards

6 Historic Discharge summary

7 Aim Design and deliver an IT application provide a complete legible and timely discharge summary –Multi-disciplinary –Electronic ordering direct to pharmacy –Improve discharge information received by GP’s in clarity and time

8 Method Project Team – Multi-disciplinary Current document –Informal discussions –Medical –Pharmacy –Nursing and admin staff Wish list

9 Method Bespoke design –Data extract-drugs name,form,regimes –Drug package/order sentences –Controlled drugs –Pharmacy roles –Logic rules - pharmacy exceptions –Dispensary/Ward work lists –Security

10 Method Version 1 –Acute Medical Unit (AMU)pilot Version 2 –AMU, Medicine and Elderly Care Design –e-Learning package: doctors induction

11 Results Since pilot in 2007, e-Discharge trust wide

12 e-Discharge summary Interactive Demonstration © Ascribe Ltd

13 Work list Dispensary specific –Pharmacist screened documents appear in any one of three dispensaries © Ascribe Ltd

14 Security Role specific access –Doctors –Pharmacist, MM technicians –Nurses, administration staff Password PIN

15 Information transfer e-Discharge Summary transfer –Hampshire Health Record (HHR) –24 hours post patient discharge Direct transfer to GP surgery –30-40 surgeries

16 Discussion e-Discharge system SUHT e-learning training Benefits –Patient –Pharmacy –Medical –Nursing and administration staff –GP’s Financial/Clinical reporting and audit

17 Discussion Issues Time consuming –Order sentences, drug packages –Common diagnoses lists specific to the clinical specialty Transfer issues –Hampshire Health Record (HHR) –GP direct

18 Lessons learnt… Multi-disciplinary –Nursing staff Senior support –Big stick approach! Communication –Junior medical staff Hardware

19 Conclusion e-Discharge Summary –Reduction in illegible discharge summaries. –Improved work flow into pharmacy. –Transformed access throughout Trust to information on discharge summaries. –Improved GP transfer of information.

20 The future Work –Outpatient module –Medicines reconciliation –Anti-coagulation ~ warfarin –DVT prophylaxis recording –Repeat Prescriptions

21 Acknowledgements ePR Projects Team Pharmacy Department SUHT –James Allen - Pharmacist

22 Questions?