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

eAMS walkthrougheAMS walkthrough

PurposePurpose

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

Acute Medication Service (AMS)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

Electronic Acute Medication Service Electronic Acute Medication Service (eAMS)(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)

eAMS Prescriber Process 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

Example eAMS GP10 form and Example eAMS GP10 form and barcodebarcode

Example eAMS GP10 form Example eAMS GP10 form (cont.)(cont.)

• Native Drug Dictionarydescription

• But where possible,dm+d code is included

• Electronic message has native AND dm+d description and code

eAMS pharmacy processeAMS 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.

eAMS pharmacy processeAMS pharmacy process

RxRxRx Prescription form(s)received at pharmacy Barcodes

Scanned

Electronic messageSent & result received

ePMSPMR

PMR

PMR processes withelectronic support

•‘Usual’ functions•Patient exemption info

RxRxRxClaim

Iterate to completethe claim

•‘Electronic’ endorsing•Virtual and Actual Pack info

RxRxRxClaim

ePMS

Issue medicationand submit claim

Paper form

Elec Msg

Variations

Prescription form is receivedPrescription form is received• Person presents at

pharmacy with prescription form

Prescription form is scanned and Prescription form is scanned and message sentmessage sent

• A prescription request message is sent immediately on successful scan

• Scanning a barcode only retrieves the corresponding electronic prescription message, no ‘linking’

ePMS

Electronic prescription information is Electronic prescription information is receivedreceived

• In this scenario the items in the electronic prescription message are dm+d coded

• Electronic prescription message in 1-2 seconds

ePMSPMR

PMR utilises electronic information to PMR utilises electronic information to support patient and item selectionsupport 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

Claim information is populatedClaim 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

Medication and claim issuedMedication 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

RemindersReminders

• 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

Other options form the main Other options form the main scenarioscenario

Prescription forms received in Prescription forms received in advance of patientadvance 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

Working with multiple Working with multiple prescriptionsprescriptions

• 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

Electronic messages without dm+d Electronic messages without dm+d codescodes

• 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

No electronic messageNo electronic message

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

Some things to consider: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

eAMS progress reporteAMS progress report

eAMS is coming…..

eAMS progress reporteAMS 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

Some things to consider: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

Supporting practiceSupporting 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