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e-Discharge Summary
Mark Pepperrell, Principal Pharmacist
Nilesh Patel, eRecords Project Analyst
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Technology Partner
• Application provider
– Our thanks to Ascribe Ltd
– www.ascribe.com
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Introduction
• SUHT local hospital care
– 500,000 people
• Regional Services ~3 million
– Neurosciences
– Cardiac
– Children’s Intensive Care
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Introduction
• Pharmacy Service
– 250 staff
– 3 dispensaries (2 sites)
– 35-40,000 items/month
• Clinical pharmacy service
– Specialist pharmacists
– Ward rounds
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Introduction
• Discharge summary
• Carbonized A4 form
– Illegible, unclear
– GP transfer via post or patient
– Pharmacy unaware completed
• Local initiatives
• New standards
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Historic Discharge summary
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Aim
• Design and deliver an IT application
provide a complete legible and timely
discharge summary
– Multi-disciplinary
– Electronic ordering direct to pharmacy
– Improve discharge information received
by GP’s in clarity and time
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Method
• Project Team – Multi-disciplinary
• Current document
– Informal discussions
– Medical
– Pharmacy
– Nursing and admin staff
• Wish list
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Method
• Bespoke design
– Data extract-drugs name,form,regimes
– Drug package/order sentences
– Controlled drugs
– Pharmacy roles
– Logic rules - pharmacy exceptions
– Dispensary/Ward work lists
– Security
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Method
• Version 1
– Acute Medical Unit (AMU)pilot - 2007
• Version 2
– AMU, Medicine and Elderly Care
• Design
– e-Learning package: doctors induction
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Results
• Since pilot in 2007, e-Discharge trust wide
e-Discharge Summary Count
7000
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Volume
5000
Month
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e-Discharge summary
Interactive Demonstration
© Ascribe Ltd
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Work list
• Dispensary specific
– Pharmacist screened documents appear in any
one of three dispensaries
© Ascribe Ltd
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Security
• Role specific access
– Doctors
– Pharmacist, MM technicians
– Nurses, administration staff
• Password
• PIN
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Information transfer
• e-Discharge Summary transfer
– Hampshire Health Record (HHR)
– 24 hours post patient discharge
• Direct transfer to GP surgery
– 30-40 surgeries
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Discussion
• e-Discharge system SUHT
• e-learning training
• Benefits
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Patient
Pharmacy
Medical
Nursing and administration staff
GP’s
• Financial/Clinical reporting and audit
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Discussion
Issues
• Time consuming
– Order sentences, drug packages
– Common diagnoses lists specific to the
clinical specialty
• Transfer issues
– Hampshire Health Record (HHR)
– GP direct
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Lessons learnt…
• Multi-disciplinary
– Nursing staff
• Senior support
– Big stick approach!
• Communication
– Junior medical staff
• Hardware
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Conclusion
• e-Discharge Summary
– Reduction in illegible discharge
summaries.
– Improved work flow into pharmacy.
– Transformed access throughout Trust to
information on discharge summaries.
– Improved GP transfer of information.
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The future
• Work
– Outpatient module
– Medicines reconciliation
– Anti-coagulation ~ warfarin
– DVT prophylaxis recording
– Repeat Prescriptions
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Acknowledgements
• ePR Projects Team
• Pharmacy Department SUHT
– James Allen - Pharmacist
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• Questions?
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