Notes
Slide Show
Outline
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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
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Greater Glasgow NHS Board
    • 1 year eMM Project Manager based in Glasgow
    • eMM Research
    • Project Scope, Planning, Costing & Startup
    • eMM Umbrella Programme
    • Community Pharmacy
    • eRx Pilot
    • Process Mapping
    • OBS/Specification of requirements
    • Initial shaping of Full Rollout (4200 beds, 232 ward, 20 sites)
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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
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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
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Project Planning – Stakeholder Mapping
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Community Pharmacy
    • ETP Trials > Watching  Brief
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eRx 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
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eRx 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
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EPMA Pilot
    • Scope change – Medicines Administration
      • More Risk but More Benefit
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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
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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
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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
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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
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EPMA Pilot
    • Decision put EPMA pilot on hold – focus on MM, Evaluation, Process Mapping & EPMA OBS/Requirement spec.
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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)
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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
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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
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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
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Comparison NHS & Commercial
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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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