Orion Health has been working with Scottish health boards since 2004, when what is now their Electronic Health and Care Record (EHCR) went live at NHS Greater Glasgow and Clyde (NHSGGC). Scotland has been ahead of the global curve generally with digital transformation, getting shared care records in place to enable health and care professionals to access appropriate patient information long before other regions. Orion Health software is currently deployed in 10 health boards including the NHS National Waiting Times Centre and has links to a further two boards. This means that our technology supports the care of over 75% of the Scottish population. Since 2017, health boards have been sharing information between each other, for example through the North of Scotland Care Portal, which has supported patient care across the traditional boundaries of the four boards involved since 2019.
So, the foundations of appropriate sharing of patient information to support better care are largely in place in Scotland, and indeed across the UK & Ireland, so where to next? Given that medication is the most common intervention when caring for a patient, but also one of the most likely to go wrong, medicines management is a focus area in Scotland.
Traditionally, information on a patient’s medication history has been disjointed, with pieces of the puzzle residing within GP prescriptions, community pharmacy dispensaries, hospital discharge summaries and more. Even within a shared care record different terminologies, contradictory accounts and multiple prescriptions from different care settings can cause confusion. A great deal of clinical time has been spent, particularly on hospital admission and discharge, attempting to reconcile these information sources to establish the medications that a patient has previously taken, is taking now and what they should take going forward, then sharing this information with the appropriate clinicians and caregivers. When healthcare providers have the tools in place to automate this process and create an accurate, reconciled medication list across care settings, medication errors are reduced, as are incidences of patient harm and clinician time wasted trying to piece together a patient’s medication record.
Orion Health’s Medicines Platform is built on the latest FHIR interoperability standards and enables an up-to-date, comprehensive view of a patient’s medication history to support effective and safe care delivery across settings. Because data sharing means better care, better outcomes and more efficiency, the Medicines Platform is built for interoperability. This means that a patient’s consolidated medication record can easily be shared with other appropriate digital healthcare solutions, for example a Patient Portal, through which a patient could access their own consolidated medication record in addition to GP, as well as hospital and community pharmacy systems and more.
In 2019, NHSGGC completed the rollout of their medicines management solution, integrating with the national Emergency Care Summary (ECS) to pull on-demand medications data and normalise it as structured data in our open Medicines Platform. This gives health and care staff across 11 different hospital sites a more complete picture of the medications a patient is taking when they are admitted. It also electronically generates an electronic immediate discharge letter for the GP to explain why medications were stopped, changed, or prescribed for the first time while one of their patients was in hospital. Having recently implemented a hospital electronic prescribing and medicines administration (HEPMA) system, NHSGGC are integrating this new hospital system with the Orion Health Medicines Platform to deliver a fully digitised and seamless solution for admission, inpatient, and discharge prescribing across acute and community domains. As NHSGGC’s EHCR is expanded out to allow access from community pharmacy, optometry, NHS24 and the Scottish Ambulance Service, its support for patient health and care in Scotland will be further enhanced.
Following in NHSGGC’s footsteps, the NHS National Waiting Times Hospital also deployed our Medicines Platform to support their digital immediate discharge letter requirements. The North of Scotland Care Portal will be next in Scotland to adopt the Medicines Platform, with the solution looking to go live in 2022 and potential HEMPA integration to follow.
With the Orion Health Medicines Platform deployed in a growing number of Scottish health boards and with the infrastructure already in place to share patient information across 75% of the population, Orion Health is supporting the Scottish Government’s refreshed digital strategy to help improve the care and wellbeing of people in Scotland by making best use of available digital technologies.
In England, the Dorset and Hampshire and Isle of Wight Care Records form part of the Wessex Care Record’s ‘One Medication Record’ project. This also expands the medicines reconciliation use case beyond the walls of the hospital to deliver a consolidated medication record across a wide range of care settings including community pharmacies, mental health and drug and alcohol support systems. This should make it easier for pharmacists to spot and confirm medicines changes, track repeat medicines and make clinical assessments.
The time is now to sharpen the focus on digitising medicines management and sharing information across traditional care boundaries within healthcare to reduce errors and to improve patient experience and outcomes. Find out more about Orion Health’s Medicines solutions.