Making it work for you Print E-mail
Written by Ian Taylor, Rx Systems Ltd   

The role of the community pharmacist has changed substantially and will continue to expand. No longer slaves to the dispensary bench, pharmacists are being encouraged to spend time in patient consultation and embrace new responsibilities such as medicines use reviews (MURs).

Spending more time with patients will place significant pressures on time and workload for pharmacists who are already very busy. Those who are successful in their new role will be so for a number of reasons, but effective time management will be an absolute priority for those who want to make the most of new opportunities. IT can play a crucial part in this.

The introduction of new contracts for England, Wales and Scotland will need those who supply pharmacy IT to review their services. The system houses gaining most benefit will be those that rise to the challenge set by operating in distinct markets and can focus on delivering a fully managed IT service solution to community pharmacy. However, the result will be a marked change in how systems are supplied and supported to community pharmacy.

To date, system houses have responded to the basic needs of their customers by concentrating on delivering dispensary software and hardware and its support. But now that we have different pharmacy contracts in place in each country, system houses can no longer take this approach. The IT solutions required for Scotland, England and Wales require different deliverables (although they have some common standards) to allow their respective , Electronic Transmission of Prescriptions (ETP) projects to work.

The challenge for system houses is to deliver common functionality across the countries while taking into account bespoke service solutions as dictated by their respective healthcare strategies. More adept system houses will solve this, but others will fall by the wayside. We are already seeing the start of system house differentiation in the markets as a number have chosen not to comply with the initial requirements of eMAS in Scotland.

Key consideration


While there are different approaches for each country, there are some key considerations for pharmacies when selecting an IT partner if they are to operate effectively and interact with other healthcare professionals. Over the last few years we have seen an increase in connectivity outside the closed pharmacy environment and the use of the technology with the introduction of NPAnet. NPAnet, being a secure network environment for community pharmacy, understood the need to protect sensitive data but also cater for professional and commercial needs.

In many respects it has set the standard and allowed the existence of commercially available network aggregators to connect to N3. Alongside NPAnet (Securnet) there are two other aggregator options in the form of UniChem and Pipex. All vary in the service deliverable and, like system houses, will no doubt differentiate themselves in the services they deliver.

Image
Figure 1


Figure 1 shows the configuration of NPAnet and the flexible approach it provides in connecting pharmacies to N3 and Electronic Prescription Service (EPS), while also allowing its use for business needs e.g. broadband orders to the wholesalers.

A number of the tools employed and points covered below are relevant to any managed service available in each of the countries, but these major on EPS for English contractors as this has been the area that has prompted most recent debate. The underlying principle is that these tools need to be present if any pharmacy is to receive a managed and workable solution.

In practical terms


But what does that mean in practical terms? We have mentioned that traditionally system houses have delivered a PMR application that runs on a computer either sourced by the pharmacy or provided by the system house. The system house supplied hardware is maintained under a service level agreement. So what is it that a pharmacy needs from a service provider/ system house over and above this traditional approach in delivering a managed service for EPS?

  • Dedicated telephone line upgraded to N3 compliant broadband and managed Cisco Router;
  • Asset management software and remote diagnostics;
  • Antivirus applications on all machines;
  • Disaster recovery solutions for systems and data;
  • EPS compliant software (current compliance status can be viewed at www.connectingforhealth.nhs.uk );
  • Windows XP Pro system;
  • Barcode scanner and smart card reader per terminal;
  • Pharmacist issued smart cards – available from primary care trusts.

Some of the above have been well-documented to date and their relevance to EPS is straightforward and understood. Therefore, we will concentrate on the top four.

Dedicated telephone line upgraded to N3 compliant broadband
This, when connected to a Cisco Router, will manage a systems connection to N3. As an example of the high level of support, the router is maintained on a four working hour fix. The line is provided as a dedicated and resilient line to the pharmacy to minimise connectivity errors by not allowing other communications peripherals, such as fax machines, to be connected to the same line. This link introduces fast communications lines to the pharmacy. Although prioritised for EPS, these lines must allow other uses of the broadband line for commercial and professional activities e.g. virtual private networks (VPN). To date, this facility has typically been available only to large groups.

The multiple use of the line is an approach accepted by Connecting for Health and something the Welsh Assembly is embracing in its strategy. The Scottish Executive Health Department should note this varied need as it continues to restrict use of the broadband line for both Scottish contractors and system houses.

We have noted that there are three network aggregators accredited to connect to N3 in England. For each system house to deliver an effective and managed service, it needs to partner with a specific network aggregator. It therefore makes sense to get the N3 connection from a chosen system house and not contract with a network aggregator direct.

Full asset management of the IT system EPS cannot be delivered effectively without full and proactive management of a pharmacy’s IT systems. It is important to maintain connection to N3, manage PMR software and patch releases (Windows updates) and actively monitor EPS to ensure the availability of the service. This proactive monitoring of hardware and software will work towards maintaining the availability of EPS for pharmacy.

Antivirus applications on all machines
This should be a prerequisite for any system connecting outside a closed pharmacy environment. An IT provider should include antivirus protection on all machines connected to the local area network, which in turn are connected to N3 and the Internet. Failure to protect systems will result in the likely disruption of the local systems, but also the potential introduction of viruses across the N3 network. Any pharmacy that is seen as introducing a virus would be taken off the N3 network, resulting in significant business interruption.

Full disaster recovery of your IT system and data systems and data can fail in all sorts of ways and proactive management of systems data is important to achieve a minimum downtime. This is particularly relevant to Release 2 when the paper prescription is theoretically replaced with an electronic version. Other failures requiring off-site disaster recovery are computer component failures, system theft, damage and viruses. At the moment, it’s important not to lose a system or data, but with the introduction of EPS and the likely removal of the paper prescription, failure of a system or data would be disastrous for a pharmacy business and the professional service it provides to the community.

Summary


It is no surprise that the delivery of EPS comes at a cost. Considering the IT allowances given to pharmacy to date and the ongoing money available for pharmacies to claim for N3 connectivity and service support for EPS, system houses must deliver a ‘total turnkey solution’, whether they operate in Scotland, England or Wales. Those suppliers who choose to minimise the service offering may not be fit for purpose, particularly if they opt out of specific markets.

To deliver a fully managed and resilient pharmacy IT solution, the overall IT service model for pharmacy is changing. Accepting that pharmacy will now give the IT systems the investment allowed, the managed service opportunities in meeting both professional and commercial needs can be a reality.
 
< Prev   Next >
[ Back ]