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3	Background Degree in computer science & MBA 22 years in IT Every role – analysis, programming, support, quality, project management Mostly commercial organisations financial services, banking, retail, travel, manufacturing, telecommunications & consultancy 3 years deputy group IT director – Lloyds pharmacy and AAH pharmaceuticals Public sector The Law Society (£40m transformation programme) Social housing 2001 set up Transit Point
4	Greater Glasgow NHS Board 1 year eMM Project Manager based in Glasgow eMM Research Project Scope, Planning, Costing & Startup eMM Umbrella Programme Community Pharmacy eR_x Pilot Process Mapping OBS/Specification of requirements Initial shaping of Full Rollout (4200 beds, 232 ward, 20 sites)
5	eMM Research & Context EHR, EPR levels 1-6 & Timescales National Service Frameworks (NSF’s) Integrated Care Records Services (ICRS) Procurement Rationalisation (NISP, NASP, LSP) Confidentiality & Privacy UKCPRS SNOMED-CT X NOT SCOTLAND Spoonful of Sugar & Organisation with a Memory Contacts
6	Project Planning Project Planning - Programme board, Project management, Project Office Decision: To Pilot or Not? Project Briefs & PID for eMM Programme eRx Pilot OBS Full Rollout Community Pharmacy Project Plans, Dependencies & Roadmap Project Organisation Document Communication Plan Stakeholder Mapping
7	Project Planning – Stakeholder Mapping
8	Community Pharmacy ETP Trials > Watching Brief
9	eR_x Pilot Allow Time Cost 24x7 support (IT, Pharmacy, Supplier) Disaster Recovery Plan Hardware & Technology Selection Mobile Devices & Robustness Fast Moving, e.g., Smart Card Thick/Thin Client, Web Based, Portal Wireless LAN & Security Size to Cover Peaks Plus Growth Data Protection & User Authentication Software Selection – Functional specialist cf. Generalist
10	eR_x Pilot Training IT Illiteracy & Phobia (Nurses) Application (on-call JHO) Superusers Clinical Risk – Testing Project Risk – Shortage of Nurses & Pharmacists Drug Trolley Redesign NHS Number & CHI Number Choice of Pilot Site - General Ward not Critical Care Evaluation 3 months
11	EPMA Pilot Scope change – Medicines Administration More Risk but More Benefit
12	Medicines Management MM structure Overlap (Drug Trolley might Disappear?) Definition Original Packs 28 Day Supply Patient Lockers Patient’s Own Medicines (Consent) Medicine Re-use Self Administration (Consent) Responsibility from Clinician to Nurse & Pharmacist, Nurse Partly Covers Pharmacy Out Of Hours
13	Medicines Management - Benefits Speed up Discharge Process Reduce Nurse Time on Supply & Admin Automate process means more time NTPP Better weekend Cover Lower Cost through Better Use of Drugs Compliance (Self Administration) Better Primary & Secondary Care Integration Recent Example
14	Medicines Management – Challenges & Opportunities Timing - eRx then MM harder than MM then eRx Patient’s Own Controlled Drugs Primary/Secondary Care Costing Changing SOP’s and Unions
15	Medicines Management – Challenges & Opportunities Flexible Systems Technological Change (Robotic Dispensing) Support Future Process Change Stock Control of Patient Lockers MA & Technician Check Trigger Re-Supply Parallel Imports/Original Packs Undo Button Ward re-labelling
16	EPMA Pilot Decision put EPMA pilot on hold – focus on MM, Evaluation, Process Mapping & EPMA OBS/Requirement spec.
17	EPMA & MM Process Maps Map Processes - Current & Future (EPMA & MM) High Level Admission Clinical Management Drug Administration IV Administration Stock Management Discharge Cardiology (EPMA Pilot team) > Generic > HEMPA (Scottish Top 16 EPMA & MM Guidelines)
18	EPMA & MM OBS/Requirement Spec. EPMA/Pharmacy Close Coupling Starting Point – Liverpool/Derby Generic Pharmacy & EPMA spec. Turn into Scottish Document 40 hours Multi-Disciplinary Workshops Clinician Input Biggest Risk Careful Wording Piecemeal IT development Standardisation Consultants Don’t Always Agree
19	EPMA & MM OBS/Requirement Spec. Homeopathic & Herbal Remedies System Integration & Interoperability Single Login & Clinical Portal Access to Pathology Results to Make Informed Decision Feed into DSS/Interaction Checking Automatic Triggers Extra System Flexibility/Configurability = Complexity, Cost, Unclear Process/Program Logic, RISK
20	EPMA & MM OBS/Requirement Spec. Future Link OBS to Process Maps (Patient Journey) Wider Review – Stakeholders, Clinicians, Specialisms Decisions on Legacy Systems Once OBS agreed - complete Pilot and do Full Rollout
21	Comparison NHS & Commercial
22	Conclusions IT is Change Enabler/Limiter Need Procedures to Change (People) EPMA & MM Communication & Involvement is Key Tap into Committees (Be Seen/Accessible) Project Vision Pragmatic Project Management & Experienced PM Danger Too Much Change - Prioritise Projects Allow Time, Money & Resource
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