The Pharmaceutical Journal
Vol 268 No 7202 p837-838
15 June 2002

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   Concordance
   Computer systems
   Product identification
   Council elections
   The Council

Letters to the Editor

Computer systems

Dispensary systems should be data driven

From Mr I. L. F. Nash, MRPharmS

With regard to dispensary computer systems, my argument has been that all systems are product driven, whereas in my opinion they should be data driven. If you can have sufficient confidence in the accuracy of the data in a (patient) file, then dispensing can follow without hindrance (technician checking, bar code checking or preferably both).

For example, automated dispensers can pick dispensing packs by bar code more quickly and accurately than people can, but this model fails to address accurate data entry (50 per cent of our errors at final check) or the bottle neck that is the final check, ie, correct label and product relative to the original prescription.

The role of the pharmacist should be to take responsibility for the data entry, not as an exercise in typing but by communicating with patients and prescribers as to what dosage and quantities of drugs people are consuming. Change management is the key. The pharmacist should be reviewing all medicines with any changes highlighted on screen, including compliance issues.

The introduction of software with templates and protocols for pharmacists to track the accuracy of the therapeutic record would be a good idea. I propose a non-authorised prescription file to allow pharmacists to explore patient therapy without necessarily prompting dispensing. I suggest that this is the same as the consultation notes in the doctor's system, split screen with the dispensing record.

Clinical governance (quality assurance) requires that there are hurdles between doctors prescribing electronically and patients consuming the product, unless 150 years of pharmacy experience is to be ignored. Tracking therapy over the medium term and achieving appropriate outcomes is the essence of (pharmaceutical care) practice.

Ian Nash
Sheffield

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