The Pharmaceutical Journal
Vol 276 No 7399 p534
6 May 2006

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How to work eMAS software: a guide

In a fifth article in a series about the new community pharmacy contract in Scotland, Clare Bellingham provides a guide to the basics of operating eMAS

Scottish contract 2006 series

Community pharmacists in Scotland have until 15 May to get their electronic minor ailment service (eMAS) software installed and tested. This is the deadline for claiming £500 funding towards the installation costs. A previous article described the minor ailment service, one of the four core services within the new contract (PJ, 7 January, p14). This article is about how to use the IT that supports the service.

Registering a patient for eMAS

Patients can only be registered with a pharmacy’s eMAS system if they already have an entry in the pharmacy’s standard patient medication record system. So step one of registering a patient is to check that he or she appears in the PMR system and, if not, to create a new record for that patient.

The next stage is to go into the patient registrations section of the eMAS system. The patient’s name should be entered and the system should search the PMR to bring up the patient’s details. The following details are essential: Full name, date of birth, gender, address (including postcode) and exemption status. Although the patient’s community health index (CHI) number can be added, it is not essential for registration.

Once all the data fields have been completed, an attempt to register the patient can be made by pressing the “register” button. This causes an electronic registration request to be sent to the central Patient Registration System (PRS) via the central ePharmacy Message Store. It also causes a CP2 registration form to be printed.

Three responses from the PRS are possible: registered, deferred or rejected.

Registered If the response is “registered”, the eMAS system automatically updates the patient’s record to show that he or she is now registered. It also adds the patient’s CHI number if not already present. Patients are registered for 12 months initially and then for 12 months on the date of a consultation. A confirmed registration is needed to trigger the automated payment system.

Deferred A deferred response could result from a communication problem or the patient not being easily identified on the CHI system by the PRS. This response causes a “pending registration” message to appear on the patient’s record and it may take up to seven days for a registration response to be returned. In the meantime, consultations can be performed.

Rejected A rejected response arises when a person is not eligible for the minor ailment service (eg, because they are not registered with a GP in Scotland). This response is automatically noted on the patient’s record and means that consultations may not be carried out.

Regardless of the outcome, the CP2 form should be signed by the patient (or representative) and sent to Practitioner Services. Printed on the form is a unique number (in a bar code on the side). Registrations start with the letters “RE”.

Withdrawing a patient

Patients who are no longer eligible for the minor ailment service should be withdrawn from the eMAS system. In addition, patients can choose to withdraw at any time. To withdraw a patient:

· Enter the patient registrations section

· Identify the patient’s record (as for registration)

· Once the correct record is on screen, press the “withdraw” button (This causes a withdrawal message to be sent to the PRS and for a CP2 withdrawal form to be printed.)

Two responses from the PRS are possible: withdrawn or deferred. For withdrawn messages, the eMAS patient record is automatically updated. A deferred response works in the same way as a deferred response for registration — again, it can take up to seven days for the final withdrawal to be received.

In either case, the CP2 form should be signed by the patient (or representative) and sent to Practitioner Services.

Carrying out a consultation in eMAS

The first step in a consultation is to ensure the patient is registered with the pharmacy (or has a deferred or lapsed registration in the case of patients who have not used the service for more than 12 months). eMAS systems have a registration query option through which a patient’s registration status can be checked with the PRS. A response is received in a few seconds but this does not register the patient so, if he or she has previously registered at another pharmacy, re-registration is needed.

The next stage is to go into the consultation section of the eMAS system. In a similar way to using a PMR system, the individual patient’s record should be pulled up on screen. Next, the details of the consultation should be entered in the diagnosis box. This is followed by choosing one of three outcomes: “advice given”, “refer to GP” or “medication prescribed”.

If the consultation results in advice or referral only, a consultation message is sent to the ePharmacy Message Store from where it can be accessed by Practitioner Services. In addition, a CP2 consultation form indicating either advice or referral is printed. If a medicine is prescribed, its details need to be entered at the prompts brought up on screen (medicine, dose and quantity). A maximum of two medicines can be prescribed on each CP2 form.

Once the medicine’s details are entered, the item can be dispensed as normal. The PMR system will bring up the details from the eMAS entry and the usual dispensing procedure can be completed. The final stage is for an eMAS endorsement screen to appear. On completion of this information, an electronic message is automatically sent to the ePharmacy Message Store and a CP2 consultation form is printed showing the medication prescribed. Whatever the outcome, the CP2 form should be signed by the patient (or representative) and sent to Practitioner Services. Bar codes on consultation forms start with the letters “CE”.

Consultations can be cancelled (eg, if an error is spotted) before or after the CP2 form has been printed. The consultation should be deleted from the patient’s record and the incorrect CP2 form destroyed. Practitioner Services can only obtain the information from the ePharmacy Message Store by scanning the bar code on the CP2 form: no form means no information is pulled down.

Incomplete transactions and updates

If a patient’s registration has been deferred and a consultation is carried out, then a record of the consultation will be placed in the incomplete transactions section on the system. Once the CHI is known (ie, when the registration message arrives), the CHI number will be automatically added. However, it must be entered by hand on the associated CP2 form (which should have been retained separately). The CHI number can also be manually entered on the eMAS system if it becomes known by other means.

Deferred registration and withdrawal messages need to be updated daily. This is either an automatic or a manually initiated process, depending on the eMAS software.

ACKNOWLEDGMENT: This guide could not have been produced without the input of Catriona MacDonald, community pharmacy IM&T facilitator, NHS Tayside, and Alison Strath, principal pharmaceutical officer at the Scottish Executive Health Department.