1. ePharmacy Programme: the electronic Acute Medication Service (eAMS) ePharmacy Programme: the electronic Acute Medication Service (eAMS)

2. eAMS walkthrough

3. Purpose To walk through the electronic Acute Medication Service (eAMS) element of the new community pharmacy contract for pharmaceutical care

4. Acute Medication Service (AMS) The provision of pharmaceutical care by community pharmacists for acute episodes of care –GP prints GP10 with a barcode and electronic message –Patient presents GP10 in the pharmacy –CP scans barcode to retrieve the prescription details –Prescription dispensed (reduced data entry) –Electronic message generated and sent to ePMS –ePay supports eRemuneration and eReimbursement –In other words – the electronic transfer of prescriptions

5. Electronic Acute Medication Service (eAMS) Process at the GP practice almost unchanged –Prescribing activity creates an electronic message/s and corresponding bar-coded GP10 form/s Process for patient unchanged Process at the pharmacy involves scanning the bar code –pulls down the prescribing data –pre-populates the dispensing screen and subsequent label ePay starts to improve PSD’s payment processes ISD gets a richer set of data (not just ‘paid’ information)

6. eAMS Prescriber Process Prescriber process largely unchanged Uses existing prescribing system to produce : –Bar coded eAMS GP10 form –Corresponding electronic message sent to ePharmacy message store ready for use by the pharmacy –Prescribers using native dictionary to prescribe mapped to dm+d

7. Example eAMS GP10 form and barcode

8. Example eAMS GP10 form (cont.) Native Drug Dictionary description But where possible, dm+d code is included Electronic message has native AND dm+d description and code

9. eAMS pharmacy process ‘Main’ scenario outline Person presents with a prescription form and wishes the items to be dispensed immediately. The prescription form is scanned and the electronic message is received. Items are dm+d coded. PMR uses the electronic information to support the selection of the required item/s. The item/s are endorsed and the claim is submitted as the item/s are issued.

10. eAMS pharmacy process Rx Prescription form(s) received at pharmacy Barcodes Scanned Electronic message Sent & result received ePMS PMR PMR processes with electronic support ‘Usual’ functions Patient exemption info Rx Claim Iterate to complete the claim ‘Electronic’ endorsing Virtual and Actual Pack info Rx Claim ePMS Issue medication and submit claim Paper form Elec Msg Variations

11. Prescription form is received Person presents at pharmacy with prescription form

12. Prescription form is scanned and message sent A prescription request message is sent immediately on successful scan Scanning a barcode only retrieves the corresponding electronic prescription message, no ‘linking’ ePMS

13. Electronic prescription information is received In this scenario the items in the electronic prescription message are dm+d coded Electronic prescription message in 1-2 seconds ePMS PMR

14. PMR utilises electronic information to support patient and item selection Can match patient and offer update PMR utilises dm+d information Many opportunities for PMR to streamline this process – E.g. could recognise that these exact prescription items have been received before and offer what was done ‘last time’ Other PMR functions (e.g. labelling) remain the same although again may be streamlined PMR

15. Claim information is populated Requirements – Endorsement information (electronic) VMPP or AMPP – Exemption status consider point of capture Endorsement information completed for each item until all claim information is complete Can be completed ‘in-line’ or ‘parked’ at any point for completion later e.g. to allow endorsing at the end of the day. Ready to claim

16. Medication and claim issued Medication is issued to patient Claim message is confirmed and sent (could have been default action) Prescription form is set aside for submission (as now) Claim sent ePMS

17. Reminders Usual PMR processes of owings etc. still apply Electronic claim is submitted at same point paper would be Electronic endorsing support will be provided by the systems Patient exemption status to be captured electronically

18. Other options form the main scenario

19. Prescription forms received in advance of patient Prescriptions may arrive through other routes –Prescription posted –Collection from a general practice –Delivery from a general practice / practitioner Variations –No impact on previous process –Work in advance as you do now

20. Working with multiple prescriptions Scanning can be ‘batched’ –Do not move straight to processing received message –Scan multiple prescriptions forms and have the results received in the ‘background’ individual request for each bar code – they are not linked –Operate from a ‘work list’ to manage and select prescriptions for processing

21. Electronic messages without dm+d codes Electronic prescription messages received and some or all items are not dm+d coded –Items are ‘ordered’ - coded ones first –Where not coded the PMR support is lessened Alternative method used – possibly as current with search terms entered Patient can still be matched electronically Claim information completed electronically –for both coded and non coded items Both electronic and paper prescriptions forms submitted

22. No electronic message No electronic message in timely manner Work from the paper forms Claim electronically

23. Some things to consider: Primary source of capturing barcodes will be scanning –Consider where to scan in the pharmacy Patient exemption status needs to be captured –Consider capturing this in advance where possible Electronic endorsement required for ePay –PMR system will support this but consider how this will happen / be checked Both electronic claim and paper prescription form are submitted –Remember the electronic claim information will take precedence over paper Claims can be cancelled or re-submitted within a time scale

24. eAMS progress report

25. eAMS is coming…..

26. eAMS progress report GP systems –5 out of 5 completed SEF testing –all 5 are in beta testing –Roll out of software from April 2007 –Complete June 2007 CP systems –Functional specifications and requirements with system suppliers –Beta testing from July 2007 –Roll out starts from September 2007

27. Some things to consider: Primary source of capturing barcodes will be scanning –Consider where to scan in the pharmacy Patient exemption status needs to be captured –Consider capturing this in advance where possible Electronic endorsement required for ePay –PMR system will support this but consider how this will happen / be checked Both electronic claim and paper prescription form are submitted –Remember the electronic claim information will take precedence over paper Claims can be cancelled or re-submitted within a time scale

28. Supporting practice SPGC –Proposals for eAMS / eCMS preparatory work linked with populating PMR with key data SEHD –Patient information leaflet –NES Implementation pack –Incentives for processing prescriptions electronically NSS –Helpdesk –Website NHS Boards –GMS and CP IM&T facilitators –Champions