1. eMAS Walkthrough Registration, registration updates and consultation

2. Core Infrastructure Components

3. Prior to ePharmacy the systems and communications infrastructure consisted of the computer system in the pharmacy and the payment processing and associated systems at practitioner services with communication via paper prescription forms and reports. Practitioner Services CHI Pharmacy Payment processing systems

4. Practitioner Services CHI Pharmacy Payment processing systems N3 network Community pharmacies need to have a connection to the N3 network. This is achieved as an independent connection or as a ‘corporate’ connection.

5. Practitioner Services CHI Pharmacy ePharmacy Message Store Payment processing systems N3 network The ePharmacy message store provides a secure, resilient, single point of contact for all messaging for MAS and all future ePharmacy applications.

6. Practitioner Services Patient Registration System CHI Pharmacy ePharmacy Message Store Payment processing systems N3 network Remunerating pharmacies on a capitation basis requires a central patient registration system (PRS) to support this. The system contains the rules for patient registration and integrates with the payment systems and the CHI system to provide CHI numbers to pharmacies.

7. Practitioner Services Patient Registration System CHI Pharmacy ePharmacy Message Store Payment processing systems N3 network MAS The Minor Ailment Service requires new ways of working in the pharmacy. Pharmacy systems have developed support for the new service as well as developing the messaging support required to participate in ePharmacy.

8. Practitioner Services Patient Registration System CHI Pharmacy ePharmacy Message Store Payment processing systems N3 network Electronic messages MAS Electronic messages are used in addition to paper CP2 forms. The messages allow for ‘real time’ responses to registration requests and the delivery of CHI numbers. The electronic data is used in place of the paper forms in payment processing to vastly improve data capture.

9. Registration

10. Registration Process Individual’s data –Name –Address –Date of birth –Exemption status Enter data on PMR system Central Patient Registration System (CPRS) via N3 Registration confirmed with CHI number

11. Practitioner Services Patient Registration System CHI Pharmacy ePharmacy Message Store Person presents and wants to register for MAS.

12. Information is captured and added to the pharmacy system (or an existing record is updated). Practitioner Services Patient Registration System CHI Pharmacy ePharmacy Message Store

13. Practitioner Services Patient Registration System CHI Pharmacy ePharmacy Message Store CP2 form for registration is printed and person signs to confirm their exemption status. The person can leave at this point.

14. If the CHI is not known at the time of registration the DoB is placed in CHI field and 4 digits are added at the end.  ‘0008’ shows a patient born in the 19 th Century  ‘0009’ shows a patient born in the 20 th Century  ‘0000’ shows a patient born in the 21 st Century Pharmacy details are automatically added.Patient details are automatically added. Further automatic additions include:  Date  PS Contractor Code  RPSGB Reg Number CP2 type and sex of patient is automatically printed. A unique barcode is created on the CP2 registration form. The barcode number is also part of the registration message sent from the pharmacy PMR. A registration barcode number begins with the letters RE.

15. Registration request Practitioner Services Patient Registration System CHI Pharmacy ePharmacy Message Store … and an electronic message is sent.

16. Registration message Practitioner Services Patient Registration System CHI Pharmacy ePharmacy Message Store Registration request The message is directed via the ePharmacy store to the Patient Registration System (PRS).

17. Practitioner Services Patient Registration System CHI Pharmacy ePharmacy Message Store Registration message Registration request The PRS applies the registration rules and locates the person on CHI then records the person as registered at the pharmacy.

18. Registration Response (with CHI) Practitioner Services Patient Registration System CHI Pharmacy ePharmacy Message Store Registration message Registration request  Registration details updated PRS then replies with the registration status and CHI number and the information is automatically updated on the pharmacy system. Registration is complete.

19. Practitioner Services Patient Registration System CHI Pharmacy ePharmacy Message Store Registration Response (with CHI) Registration message Registration request Image Store Later… CP2 registration forms are submitted by the normal route to Practitioner Services where they are imaged and stored. (The registration is already complete).

20. ‘deferred’ registration

21. Recap: Patient presents to register. The patient’s details are added or updated on the pharmacy system. A CP2 for registration is printed and a registration message is sent. The PRS responds confirming registration and returning CHI number. The patient record is automatically updated. Practitioner Services Patient Registration System CHI Pharmacy Registration request Registration message ePharmacy Message Store  Registration details updated

22. Practitioner Services Patient Registration System CHI Pharmacy Registration request Registration message ePharmacy Message Store What if a registration response is not received? There are a number of reasons why this might happen…

23. Practitioner Services Patient Registration System CHI Pharmacy Registration request Registration message ePharmacy Message Store The patient may not be uniquely identified on CHI. (Perhaps details match a number of entries, e.g. twins or perhaps the patient has only recently moved to Scotland). 

24. Practitioner Services Patient Registration System CHI Pharmacy Registration request Registration message ePharmacy Message Store  The patient registration service may be unavailable or undergoing routine maintenance.

25. Practitioner Services Patient Registration System CHI Pharmacy Registration request Registration message ePharmacy Message Store  The ePharmacy message store may be undergoing routine maintenance or the connectivity from the pharmacy may be temporarily unavailable.

26. Practitioner Services Patient Registration System CHI Pharmacy Registration request Registration message ePharmacy Message Store   ‘Pending’ registration – OK to proceed Important. If any of these events occur there is no interruption to MAS provision. The patient is recorded as ‘pending’ registration and a MAS consultation CAN be performed. The registration request will be completed.  

27. Practitioner Services Patient Registration System CHI Pharmacy Registration request Registration message ePharmacy Message Store     There is resilience built in at each stage. A process on the pharmacy system will attempt the resend the message taking care of even prolonged communication interruptions.

28. Practitioner Services Patient Registration System CHI Pharmacy Registration request Registration message ePharmacy Message Store    There is resilience built in at each stage. If PRS cannot be contacted in ‘real time’ then the message will be delivered in ‘batch’ for processing overnight.

29. Practitioner Services Patient Registration System CHI Pharmacy Registration request Registration message ePharmacy Message Store   PRS Operations There is resilience built in at each stage. If a unique match cannot be found PRS operations team can manually find the correct patient.

30. Practitioner Services Patient Registration System CHI Pharmacy ePharmacy Message Store The registration response is delivered via a registration update once completed.

31. Practitioner Services Patient Registration System CHI Pharmacy ePharmacy Message Store Registration updates The patient registration delivers registration updates to the ePharmacy message store. (These include completed deferred registrations and changes notified from CHI).

32. Practitioner Services Patient Registration System CHI Pharmacy ePharmacy Message Store Registration updates Registration update request Registration update response  Registration details updated The pharmacy request registration updates (suggest daily) and these are delivered to the pharmacy system where the patient records are updated.

33. Registration Updates Practitioner Services Patient Registration System CHI Pharmacy ePharmacy Message Store Registration updates Registration update request  Registration details updated  Overnight Process Deferred registration results Withdrawal Death Care home Registration at another pharmacy Lapsing pharmacy Roll-on

34. Consultation

35. Care Provision Person presents at their pharmacy Pharmacist checks their eligibility Pharmacist consults with person Pharmacist offers –Treatment and advice –Advice only –Referral –Associated healthy lifestyle advice

36. Pharmacy Practitioner Services Payment Processing Image Store ePharmacy Message Store Person presents for a MAS consultation.

37. Pharmacy Practitioner Services Payment Processing Image Store ePharmacy Message Store  The person’s registration status is checked on the pharmacy system and eligibility re-confirmed.

38. Pharmacy Practitioner Services Payment Processing Image Store ePharmacy Message Store Treatment Advice Referral  The person and pharmacist consult deciding on an outcome.

39. Pharmacy Practitioner Services Payment Processing Image Store ePharmacy Message Store Treatment Advice Referral  Labels Information is recorded on the pharmacy system to support the dispensing and labelling process (if treatment is required).

40. Pharmacy Practitioner Services Payment Processing Image Store ePharmacy Message Store Labels A CP2 form is printed (the information is gathered as a by product of the labelling process). The pharmacist signs the CP2 form and the person signs to confirm their exemption status. The person can leave.

41. 1.If the CHI is not returned following a registration the consultation can still go ahead. 2.The CP2 consultation form will be printed as normal but the CHI will be missing. The patient signs the CP2 and can leave the pharmacy. 3.Before you can send the CP2 consultation form to Practitioner Services, you must wait until you receive the CHI in a message and hand write it onto the form. Endorsing information is added to the CP2. A maximum of 2 items may be dispensed during 1 eMAS consultation. If you have given advice or referred a patient to their GP, this will be indicated on the CP2 consultation form. A unique bar code is created on the CP2 consultation form. The barcode number is also part of the consultation message sent from the pharmacy PMR. A consultation barcode number begins with the letters CE.

42. Pharmacy Practitioner Services Payment Processing Image Store ePharmacy Message Store Consultation Claim Acknowledgement Labels … and an electronic claim message is sent and receipt is confirmed by the ePharmacy store. (Note: the claim has not yet been verified and passed for payment). Consultation is complete.

43. Pharmacy Practitioner Services Payment Processing Image Store ePharmacy Message Store Labels Consultation Claim Acknowledgement Later… The CP2 forms are submitted by the normal route to Practitioner Services.

44. The barcode on the form is read and the electronic message is retrieved. The electronic message information is used in place of the information that would otherwise be scanned from the CP2 form. Note: handwritten information is not used! Pharmacy Practitioner Services Payment Processing Image Store ePharmacy Message Store Read barcode & get message Labels Consultation Claim Acknowledgement

45. Pharmacy Practitioner Services Payment Processing Image Store ePharmacy Message Store Read barcode & get message Labels Consultation Claim Acknowledgement The CP2 forms are imaged and stored.

46. Questions?