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Latest figures from NHS Connecting for Health (CfH), the Government
agency delivering the National Programme for IT in England reported that
by 23
August pharmacists had transmitted 3,525,441 prescription messages using
the electronic prescription service (EPS). The number of pharmacists who
had registered for an EPS smartcard with their primary care trust, to enable
them to use the new prescription system, was 13,682 — nearly four
times the number in April.
As these figures were released it became clear that, from this month, community
pharmacists should begin to witness significant expansion in the introduction
of EPS, since most pharmacy system suppliers have reported that they are
on the verge of being able to offer the system to pharmacists nationally.
The picture emerging last month, based on the results of a survey carried
out this summer by The Pharmaceutical Journal, is that the suppliers have
developed their systems to meet the demands of the new pharmacy contract,
from essential to advanced services. [These suppliers will also provide
systems for Wales but the EPS process is expected to be different. Guidance
will be issued shortly on how to choose the best upgrade.]
Most plan to offer electronic remote technical support to pharmacists in
order to avoid disruption to businesses. They are, however, also offering
the option of on-site support to resolve a problem which cannot be fixed
remotely, usually promising that it can be sorted out within a maximum
of eight hours.
Nearly all the companies are offering EPS to community pharmacists as a
total package consisting of software, hardware and connectivity, and they
are confident that their systems are secure. The training options on offer
vary between the companies, from remote internet training to training days
for groups of pharmacists at an agreed venue.
Most of the eight pharmacy system suppliers questioned by the PJ were unable
to say how they would introduce the second phase (release 2) of EPS. Only
one supplier predicted it would be likely to charge pharmacists for the
necessary software upgrade while two others were confident that they would
not expect to charge a fee.
Accreditation and roll-out
This summer, the PJ asked eight pharmacy computer suppliers when they
expected to be able to roll out their EPS systems to community pharmacists
and
what kind of support and service the profession could expect from them.
The pharmacy chain UniChem, which is adopting the Nexphase EPS system,
also contributed its views.
The PJ survey revealed that at the time of questioning, only two EPS
systems — AAH’s
LINKEvolution and Cegedim Rx Ltd’s Nexphase had achieved full accreditation
from CfH and were being rolled out nationally to pharmacists.
AAH, which claims it was the first supplier to be accredited by CfH for
a national roll-out of its systems, told the PJ that it expects to roll
out LINKEvolution to the majority of its customers by the end of the year.
Since it was accredited in October 2005 it has brought EPS to more than
500 pharmacies, the company said.
Other suppliers, Fusion Health, Hadley Healthcare Solutions Ltd, Positive
Solutions and RX Systems, have now been accredited and expect to be in
a position to roll-out nationally in September. Cegedim Rx Ltd said its
EPS “Pharmacy manager” product was given the go ahead for a
national roll-out at the end of August, while its third EPS product, Mediphase,
is not expected to be accredited and rolled out until the end of the year.
QicSCRIPT, the EPS system from System Solutions, had also been accredited
by CfH but the company predicted it would not be in a position for a national
roll-out until October.
Pharmacy computer supplier Ascribe Plc, however, predicted its EPS system
called Park Systems Ascribe would be compliant by the end of September.
It would then be tested at five pilot sites before being rolled out nationally,
probably at the end of January 2007. A company spokesman said: “The
acquisition of Park Systems by Ascribe Plc caused an initial delay in the
development of ETP functionality as both companies sought to define a roadmap
to move the product forward. With the road map in place, the changes to
the PMR (patient medication record) product to support ETP have been completed
on
schedule.” Technical support
Ian Taylor (left), sales and marketing director
of RX Systems, discusses the company’s EPS software with
a client, Duncan Murray, managing director of C G Murray pharmacies,
Worcestershire
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Pharmacy computer suppliers have also revealed details of the technical
support they plan to offer pharmacists running ETP.
Ascribe Plc has established a technical support team at its headquarters
in Bolton, Lancashire. The team will be able to access pharmacy sites remotely
and the company was confident that problems could be resolved quickly and
accurately. Remote access also means that software updates can be made
without the need for a site visit, the company said. However, it pointed
out, it will also have a maintenance team which can, if necessary, visit
the pharmacy.
Positive Solutions Ltd has a triage system, inspected and accredited by
CfH, to deal with EPS problems that pharmacists might have.
AAH revealed that it has 13 support analysts working from its customer
systems service desk who are available to pharmacists who experience problems
with EPS. A company spokesman explained how the system works: “The
first point of contact is the first- line support officer; these officers
solve 95 per cent of calls. Problems requiring further investigation are
handled by second-line support technicians. Third-line technicians interrogate
customers’ data if required and liaise with the development team
regarding fixes and product developments.” There is also on-site
support if necessary. The support team also offers advice about hardware
and will deal with any general questions pharmacists might have about EPS
and the new pharmacy contract.
Cegedim Rx Ltd has a helpdesk service offering support and advice for all
software, hardware problems and issues around clinical data, a company
spokesman said.
It promises that it has a “truly integrated one-stop shop” support
service. “This approach is very much in the pharmacies’ interest
as they will have a single point of contact for all support issues and
will not be in a situation where they do not know who to call, or where
a supplier does not accept responsibility for issues,” said a company
spokesman.
UniChem revealed that it is offering dedicated IT support through its IT
Solutions team. Pharmacists who want to find out more about what the team
offers should ring the company’s Freefone number (0800 0322 454),
UniChem told the PJ.
RX Systems has a technical help desk for pharmacists open from 8.30am until
6pm Monday to Friday and from 9am to 1pm on Sundays. A spokesman said: “All
our systems are loaded with remote diagnostics and asset management software
to aid in fault diagnosis and proactive error detections. This means that
when you call the help desk we can easily access your system to determine
what the problem is.” The EPS will, according to RX Systems, have
to rely heavily on patient medication record (PMR) systems. A spokesman
explained: “When it is fully implemented, prescriptions will be entirely
electronic, so if your PMR system is not working you will not be able to
access prescriptions.”
The company explained that if this happens, a pharmacist would be expected
to follow national guidelines and be obliged to direct patients to the
nearest pharmacy that has EPS instead. A spokesman said: “It is therefore
really important that pharmacists are able to put right any problems they
have quickly to prevent a major impact on their business.” RX Systems
promises it will fix any problems with hardware within eight hours. It
also offers pharmacists “disaster recovery” — a back
up of systems data, off-site, which will be encrypted.
Systems Solutions is also promising a customer support help line team which
can access systems remotely. A spokesman said: “Should an issue persist
it will be handed over to our second-line support team, comprised of a
nationwide team of experienced engineers who provide 24-hour on-site support
to customers with urgent issues.”
Hadley Healthcare Solutions Ltd has boosted its team of trained IT help
desk staff by 75 per cent in the past year in anticipation of workload
increases created by EPS introduction so that it can maintain its quality
standards, the company explained.
Fusion Health Ltd said any software problems with its EPS system, called
CAPA, will be dealt with remotely since all its customers will be connected
with broadband. Issues with any hardware will be dealt with under contract
by another company, which has guaranteed it will repair or replace equipment
within eight hours.
Training
Suppliers are planning a variety of training packages to help pharmacists
with EPS.
Fusion Health Ltd said it will offer “remote” training to pharmacists
so that there is minimal disruption to their working day. “Remote
training is available at prearranged times. The CAPA training team will
be authorised to access the client’s terminal and provide training
on any aspect of the system.” Additionally there will be group training
days in a central location for pharmacists and their staff. The company
also promises to provide any in-house training which a pharmacy may require
to meet its own particular needs. UniChem said it is running a series of
off-site training days for pharmacists and dispensers. It will also provide
them with e-learning training packages.
Positive Solutions Ltd predicts no major changes to current provision because
training required for EPS has already been included in its timetable. But
it pointed out that the principle behind its training programme is that
technicians who establish the N3 connection will be responsible for training
EPS users.
Hadley Healthcare Solutions Ltd is offering a variety of training options:
on-site training, or training via the telephone or the internet. There
will also be on-screen help files and it is in the process of developing
interactive training guides as well.
Systems Solutions said it intends to train key staff in the pharmacy to
use the system, who will then be able to train other staff in turn. The
company said: “This provides the pharmacy with better value for money.” Users
will also be given manuals and guides for future reference.
RX Systems will provide on-site training for pharmacists to include how
to use the smart card, N3 access, the bar code prescription process and
how the EPS system differs from the present pharmacy computer system.
Cegedim Rx Ltd has a team of more than 40 specialist IT trainers. All pharmacists
new to the system will be given a day’s training, with the option
to request more, it promises.
AAH said pharmacists will receive their EPS training on-line. Pharmacists
will also have an EPS user guide. This training, the company explained,
follows a series of evening workshops the company ran last year for pharmacists
who intended to sign up to their EPS system. Ascribe Plc said its EPS system
already includes a training package for users. But, the company said, its
implementation team will also be able to respond to any specific training
needs pharmacists require. Contract obligations
All suppliers predicted that their EPS systems will help pharmacists
meet their obligations under the new pharmacy
contract.
Fusion Health said its system will also help meet pharmacist’s clinical
governance needs because each staff member has a personal identification
number and any tasks carried out on the system can be traced back to an
individual. Its EPS system, CAPA, also includes a medicines use review
(MUR) template. Once an MUR has been carried out it is registered on the
MUR log as well as in the patient’s file. There are also other templates
which pharmacists can use for patients with asthma and cardiovascular disease.
Another CAPA template exists for pharmacists to complete an advanced medication
review and pharmacists will also be able to record patient’s tests
results on the system. An instalments log is written into CAPA which can
help with repeat dispensing, Fusion Health said. Pharmacists will be able
to see the due date for a repeat prescription and follow up those patients
who fail to turn up when expected.
Ascribe Plc said its EPS system provides for MURs and repeat dispensing.
It also has features which can record details of patient interventions
and health-check monitoring.
AAH
A snapshot of the repeat dispensing screen that is part of AAH's
EPS system, LINKEvolution |
AAH has created an MUR “wizard” for
its LINKEvolution EPS product. A spokesman said: “This enables the
pharmacist to record information in an electronic version of the standard
form. This is integrated with
existing data in the patient’s medical record and provides the comprehensive
audit trail demanded by the contract.” There is the option to include
information about patient interventions and the system provides help with
repeat prescribing as well.
Cegedim RX said that its Pharmacy Manager and Nexphase products have
software which allows pharmacists to plan and perform MURs. There is
also the opportunity
to record clinical interventions either during dispensing or as a follow
up.
RX Systems said its EPS software meets all the essential and advanced
service criteria which pharmacists need to meet under the new contact
such as MURs,
repeat prescribing and clinical governance obligations.
UniChem confirmed that the EPS system it is using, Nexphase, can create
electronic records of MURs and has tools to help with repeat prescribing
to help pharmacists with the demands of their new contract.
Positive Solutions said its Analyst EPS system was created with the new
contract in mind right from the beginning. Details of over-the-counter
and prescribed medicines can be added to the patient’s medicines
record from any computer terminal. The software also has the capability
to enable pharmacists to record details about interventions, complaints,
repeat dispensing and prescription referrals.
Details of a patient’s medical condition, the type or amount of medicine
they are taking and their age can all be identified by the software in
the Systems Solutions EPS system, called QicSCRIPT, which can make MURs
quicker and easier to complete, according to the company. It claims that,
using the system, a pharmacist could complete an MUR in six minutes. The
system also enables patients to be contacted with a mobile text message
to remind them to take their medicine, collect a repeat prescription or
to tell them that their repeat prescription is due. QicSCRIPT also maintains
a complete patient medicines record which can be shared across a pharmacy
chain or be kept by an independent pharmacy.
Built into the system is the ability to identify the potential for medicines
interaction at the point of dispensing. There is also support for repeat
dispensing.
Hadley Healthcare Solutions Ltd said its Eclipse EPS system can help
pharmacists meet their obligations under the new contract for essential,
advanced and
enhanced services. Eclipse can also “batch” prescriptions.
Colour coding and different type fonts can be used to identify whether
items have been supplied to a patient over the counter, or whether they
are emergency or private medicines supplies. Pharmacists will have the
option to record a “significant event intervention” such as
patient being referred back to their GP on the system and it can also generate
patient information leaflets. Eclipse will also offer pharmacists an electronic
MUR template. Security and access
All suppliers were confident that their systems were secure. Ascribe
Plc said its EPS system uses encryption and is “separated via firewalls
from local network traffic”. There are also multiple authentication
checks at local, national and NHS spine levels. AAH has inbuilt anti-virus
software, the company confirmed. “AAH has also received accreditation
to provide connection to the new national network (N3) — confirmation
that our Link IT system is recognised as secure by the CfH compliance
team.”
Cegedim Rx Ltd went out of its way to reassure pharmacists that the electronic
links in its EPS systems were safe from the threat of outside hackers,
viruses and spyware. “Pharmacists can be confident that the N3 connection
is incredibly secure with multiple layers of protection,” said the
company.
Positive Solutions has “sophisticated” log-on facilities which
restrict access to users with a valid name and password. Access can also
be restricted to only certain parts of the system if necessary. There is
also a clear audit trail which can link user to event, it confirmed.
Hadley Healthcare Solutions Ltd said users have to have a confidential
password to access their system and its N3 connection was via a secure
CfH connection.
Systems Solutions, meanwhile, said its system had been designed with variable
access, depending on the needs of the user and their role within the pharmacy.
A full audit trail is also written in, the company confirmed.
The N3 connection for the Nexphase system being used by UniChem includes
virus protection, firewalls, web content filtering and intruder detection.
The company has also promised it can provide power failure protection and
data recovery if the system fails.
There is a full audit control in the ProScript EPS system from RX Systems.
Connection to N3 will be through a managed route and authorised supplier.
There will also be data back up if ProScript fails for any reason and anti-virus
software will also be built in. Meanwhile, Fusion Health said that its
CAPA product met all the security criteria it had to fulfil to be accredited
by the National Programme for IT. Release 2 charges
Looking ahead, the suppliers were divided on whether they intend to charge
pharmacists for the next stage of the EPS, called “release 2”.
This stage will build on release 1, which was designed to prove the technical
stability and safety of the system and consider its local prescribing
and dispensing processes. Release 2 is described by CfH as the “transitional
stage” where pharmacists will move towards the full introduction
of EPS.
According to the responses to the PJ summer survey, only Fusion Health
said it expected an upgrade fee for release 2 although no final decision
had been taken. RX Systems, Positive Solutions and Sys-tems Solutions said
they had no plans to levy a charge, while the other suppliers, Ascribe
Plc, Cegedim Rx Ltd, AAH, Hadley Healthcare Solutions Ltd, and UniChem,
were unable to say whether they planned to charge for the upgrade.
RX Systems said pharmacists will receive the upgrade electronically which
means it is unlikely to require a pharmacy visit. AAH predicted release
2 would be provided through a simple software upgrade. However, the other
suppliers said it was too soon to say how they planned to introduce the
next stage. The details were still being worked out.
Nearly all the suppliers are offering a complete EPS package which includes
the necessary hardware, software and connectivity.
Systems Solutions is the only supplier questioned by the PJ that is offering
pharmacists the choice to buy only the software rather than the complete
set. RX Systems also said its existing customers who are keen to use its
EPS would only need “peripheral” upgrades to their present
system.
Positive Solutions said it had taken a policy decision to offer only a
complete package for EPS. The company said: “The complexity of the
solution is such that any other option would be next to impossible to support
to the standards required by CfH.” Why choose us?
When suppliers were asked by The Journal why pharmacists should choose
them above their EPS competitors, the responses were varied.
Hadley Healthcare Solutions Ltd said its system was easy to use. It has
a “logical layout” and can be used with a keyboard, mouse or
both. It is a flexible system and if necessary settings can be controlled
from a pharmacy group head office. “Pharmacy IT is not our sideline
interest — it is our whole business, so it is clear that we are able
to focus solely on the delivery of innovative solutions to meet their needs,” the
company said.
Fusion Health said CAPA had been developed by pharmacists “out of
necessity”. “The frustrations that many pharmacists experience
from outdated models of practice in pharmacy have been directed into delivering
an efficient IT solution,” the company said. “Its core database
is brand new and therefore can cater for the many new roles that pharmacists
have to deliver now and in the future.” It is an integrated and efficient
system.
Cegedim RX described itself as the “market leader” claiming
that just under half of all UK pharmacies use its products in their dispensaries. “We
are part of a global organisation with a turnover of over £500m — we
are a stable organisation with a growing user base that will be able to
provide long-term system development and support.” It described pharmacy
IT as its “core business”. It provides high quality, customer-focused
products with “excellent” support services, it said. The company
said it cares about its customers and is committed to development and support.
Ascribe Plc said its Park product was one of the first systems to be developed
for medicines labelling and the system has evolved to support the increasing
needs of community pharmacists to become “one of the most sophisticated
dispensary systems available in the UK”. Its computer systems have
been developed by community pharmacists to address “practical business
and safety issues” and the development of EPS reflects its commitment
to helping front-line pharmacists.
The company Ascribe was founded by health care professionals and Ascribe
Plc is the market leader in medicines management, according to the company.
It focuses on solutions to improve patient care: “We believe our
experience makes us the partner of choice for retail pharmacy, both now
and in the future and see the delivery of ETP as the first step towards
the ultimate aim of integrating more closely the primary and secondary
care medicines management processes.”
Systems Solutions said pharmacy IT is “more than just EPS”.
It said its QicSCRIPT system is the result of 20 years of expertise in
pharmacy and clinical technology. “Every feature is primarily designed
to provide pharmacists with the clinical tools to conduct and record the
new pharmacy contract services, as well as to automate as many time-consuming
pharmacy tasks as possible to help pharmacists save time to deliver the
services that will help them generate more revenue for their businesses.”
Experience in community pharmacy IT for 14 years makes RX Systems the perfect
choice if pharmacists are still undecided about who should be their EPS
supplier, according to the company. It understands pharmacists who want
a system that meets the demands of the new pharmacy contract but also allows
them to dispense prescriptions quickly and in a user-friendly way. The
company recognises the importance of offering flexible solutions because
the needs of community pharmacists vary. “RX Systems will be delivering
the EPS service within the IT allowances as defined under the new pharmacy
contract and this will be guaranteed for the period of the contract term,” the
company pointed out.
Positive Solutions said its Analyst Integrated Pharmacy System provides
a “complete solution” for the pharmacy covering over-the-counter
stock and medicines as well as the patient medicines record, the new pharmacy
contract and EPS. The system is easy to use and can be operated via a mouse,
touch screen or keyboard or all three. The company provides strong support
to clients and is an independent and innovative systems provider.
AAH came forward with 10 reasons why pharmacists should select its LINKEvolution
for EPS. The system was the first commercially available EPS system to
be accredited for national roll-out and was the only one which was accredited
up until late July this year. AAH has nine months’ experience of
rolling out EPS at its pilot sites. The company takes charge of all aspects
of EPS implementation — all the pharmacist has to do is obtain their
smartcard from their primary care trust. AAH boasts it offers comprehensive
technical support, has a “close working
relationship” with Connecting for Health and more than 40 years’ experience
developing IT solutions for pharmacies.
UniChem has a dedicated technical support team which will meet the individual
needs of individual pharmacists. “We aim to take the hassle out of
EPS for our independent customers by offering a complete one-stop shop
solution,” said the company.
Scotland
When asked whether their system had the functionality to support
the new contract in Scotland, there was a mixed response.
UniChem said that the Nexphase system has full functionality for the
Scottish Electronic Minor Ailments System (eMAS). AAH said that its
LINKEvolution Version 9 includes the functionality for eMAS and has
already been implemented
at pharmacies in Scotland from April. Positive Solutions said Analyst
provides
eMAS functionality and is already being used in Scotland. “It will
provide the Scottish version of EPS in due course,” said the company.
Rx Systems confirmed it has functionality for the new pharmacy contract
in Scotland and meets phase 1 of the ePharmacy programme. QicSCRIPT is
capable of supporting the contract in Scotland, Systems Solutions confirmed.
The company said: “We are currently working on developing and delivering
eMAS functionality in QicSCRIPT.”
Hadley Healthcare Solutions Ltd confirmed that its eclipse system is
used by pharmacists in Scotland for eMAS and it plans to provide version
updates
to meet the demands of the Scottish contract. Cegedim RX said both
Pharmacy Manager and Nexphase were rolled out in Scotland with eMAS
functionality
earlier this year.
But Fusion Health confirmed CAPA did not offer functionality in Scotland. |
The
Pharmaceutical Journal