Omnicell

Integration of electronic prescribing and medicines administration (EPMA) with automation and inventory management systems.

This is a UK first by linking medicines selection to electronic prescriptions allowing selection by patient needs at ward level. A ‘closed loop’ for medicines. Integration of electronic prescribing and medicines administration (EPMA) with automation and inventory management systems.

Project Overview

To expand the use of automation in the storage of medicines from the pharmacy to wards, developing integration with the Trust electronic prescribing and administration of medicines (EPMA), stock management system and automated dispensing robot, using the same core patient and drug data. Using technology to release time to care, clinical time with patients, removing manual tasks that can be automated.

This is a step change in how we manage medicines in hospitals, designed to improve efficiency in the provision of the most common form of treatment for >97% patients, and maximise the benefits of integrated systems. The project has installed automated storage of medicines, shared by wards, reducing ward stock holding by ~40%, reducing medication errors, delays, transcription, and wasted medicines. The data interfaces create a comprehensive paperless medicines pathway using technology and information systems working together.

We are the first UK hospital to create a paperless dispensary, removing transcription by reviewing processes, changing the clinical work flow, integrating into the EPR and discharge summary, using technology to maximise benefits for patients and staff. This project takes us to the next level.

The expected outcomes are a complete paperless medicines audit trail from procurement to administration (by patient / drug / staff). Stopping transcription of the same data into different systems, reducing medication errors and waste, improving efficiency - releasing time to direct care for patients and contributing to the EPR for continuity of care.

Automated systems allow recorded access (biometric / password) to medicines with various levels of authority, including Controlled Drugs. They promote access to the right medicine for the right patient at the right time by interfacing with EPMA and EPR, and support patient level information and costing.

Pre-automation

Our stock holding value of medicines outside pharmacy is ~£200k, previously stored in medicines cupboards with keys held by the senior nurse for manual selection from a range of medicines.

Potential for wrong selection is high, delays in accessing medicines common, and preventing avoidable waste a challenge.

Stock levels were maintained by pharmacy top up service previously, visiting wards to create the supply list, returning to pharmacy to enter the order into the pharmacy JAC system, sending this to the dispensing robot, then taking the stock to the ward to replenish the cupboard.

Automated cupboards effectively self manage, sending e-orders to the pharmacy system and robot, supporting replenishment maintaining ‘first in first out’, and create a virtual pharmacy out of hours.

Using a patient based integrated system, medicines used will represent actual usage by patient rather than replace what's missing, full accountability of an annual spend of >£8m pa.

The project started in December 2013, with all required planning and purchases completed by April 2014.

Post-automation

Installation fitted in with ward improvements wherever possible to create upgraded and bespoke treatment rooms. Full roll out was completed in April 2015.

£224k funding for the project was received from the Technology Fund for Safer Hospitals, Safer Wards released by NHSE in 2013.