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Two NHS hospitals implement closed-loop medication supply using FHIR standards

The University Hospitals of Derby and Burton NHS Foundation Trust will be the first to implement NHS closed-loop medication supply using FHIR standards to improve the safety and speed of hospital pharmacy processes.

University Hospitals of Derby and Burton NHS Foundation Trust and Dedalus announce a major integration milestone for the Trust’s CareSuite EPR (Electronic Patient Record) solution, following the successful integration between the ePMA (Electronic Prescribing Medicines Administration) module and the Trust’s Pharmacy stock control system.

Debbie Loke, interim director of IT/CIO, University Hospitals of Derby and Burton NHS Foundation Trust said: ‘Implementing a new ePR is always a challenge, as processes change and cognitive load adds additional burden to our clinical and administrative teams.  Being able to support our clinical teams with these developments is not only rewarding for those using the system but ultimately provides a better service for our patients, getting them quicker access to their drugs in order that they can return to their homes and families.  This is a great example of partnership working with system suppliers and clinical teams that improves care.’

Traditionally and with potential risks, medication requests are manually copied from printed or handwritten paper documents.   This resulted in a lengthy transcribing process for the pharmacy team when entering data into the electronic stock control systems. 

The integration between the CareSuite EPR and the pharmacy department creates a ‘closed loop medication supply’ process which significantly improves clinical safety and operational efficiency. The new digitised process enables a clinician to electronically prescribe the medication, which is automatically routed to the pharmacist for checking and then passed on to the Trust’s dispensing system to issue the medicine.

The solution has a positive impact on both pharmacy and nursing staff on wards.  Within the Pharmacy stock control system, the team are provided with a safe and refined list of options for each medication request, speeding up the dispensing process, and nursing staff can quickly and easily see for themselves when the medication has been issued.

The closed-loop supply process at Derby provides an end-to-end process making use of a dispensing robot to ensure the correct physical medication is always picked.  Once double-checked, the medication is then sent to the ward, labelled for the specific patient.   

Clive Newman, chief pharmacist, University Hospitals of Derby and Burton NHS Foundation Trust said: “Our clinicians and pharmacy team are benefitting from a much more automated, efficient and accurate process.  It reduces delays in treatment and most significantly, reduces dispensing errors resulting from manual transcription.”

Colin Henderson, Regional General Manager, Dedalus Group, UK & Ireland said: ‘We are proud to be working with Derby and Burton to enhance patient safety through its EPR and provide a seamless, digital solution starting from prescribing through to medication dispensing.     Digitising the process through the EPR provides the Trust with the ability to dispense faster which is particularly beneficial when hospitals are under significant pressure.’

The electronic process is underpinned by the use of recognised healthcare standards including structured FHIR-based messaging and SNOMED CT drug terminology. Dedalus is the first EPR system vendor in the UK market to use the NHS strategic FHIR interoperability standards to deliver this in a live setting.

This standards-based implementation at Derby and Burton has the opportunity to benefit all Dedalus’ EPR customers and they do not have to change their existing pharmacy system to gain the benefits from a closed-loop medication supply process.

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