Joined up pharmacy IT and services – how do we get there?

by Stephen Goundrey-Smith, RPS Informatics Advisor

In today’s NHS, pharmacy teams are delivering an ever-widening range of services which make a real contribution to patient care. What’s more, pharmacy professionals are working in various settings – community and hospital pharmacies, but increasingly in GP surgeries, care homes and other places.

The potential for valuable service provision by pharmacy teams working across different care settings, means that the need for IT interoperability to enable integrated healthcare – and joined-up pharmacy services – has never been greater.

Good progress has been made with tactical solutions for community pharmacy access to prescribing records including the roll-out of the Summary Care Record to community pharmacists, and the use of hospital discharge e-Referral systems (PharmOutcomes and Refer to Pharmacy).

But how can the infrastructure for a fully-integrated health service be developed, to support comprehensive pharmacy services going forward?

The National Information Board’s Digital Medicines initiatives will put the infrastructure in place, but there is a need for standard formats, content and codes for clinical records which will maintain a high quality of care as well as enable electronic interoperability.

The Professional Records Standards Body (PRSB) meets this need. Following the production of standard clinical headings for hospital admission, handover and discharge by the Royal College of Physicians, the PRSB was set up in 2013 to develop and assure standards for clinical care information, to enable the introduction of shared electronic records.

Since its formation, PRSB has developed standards to cover care scenarios where accurate and timely communication of information is vital – for example, hospital discharge, ambulance records, mental health discharge summaries and a crisis care standard for recording required information in an urgent situation, for example at the end of life. In addition, PRSB has produced guidance on good practice with secure emails in healthcare and clarity of healthcare records.

Projects planned and still in progress include standards for outpatient letters, for care planning and information flows in care homes. However, PRSB recognises that clinical standards – and the IT interoperability that they enable – are only useful when they are actively adopted by in practice by healthcare professions. Their Putting Standards into Practice work stream examines the factors that affect adoption of record standards in clinical practice.

In future, both patients and professionals will access healthcare services and information from apps on mobile phones and devices. For this reason, PRSB has a strong technical work stream and is looking at the use of fast healthcare interoperability resources to enable users to access interoperable health records from a wider range of device platforms.

PRSB has developed a medicines information model to underpin its standards, and will be driving forward the adoption of dm+d as a standard for medicines coding. RPS is working with PRSB to make sure that standards meet pharmacy requirements going forwards.

Watch this space to see how pharmacy can make the most of interoperable systems.

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