Using digital tools in medicines optimisation to support transitions in care – what are the barriers and opportunities?
8th August 2022 - By Clare Tolley
Update – April 2023
In this interview-based study, commissioned by the AHSN NENC, and published in the Journal of Medical Internet Research- Medical Informatics, a team of Newcastle University based researchers held in-depth discussions with 23 stakeholders across the North East and North Cumbria region to answer the questions of:
What systems are being used to transfer information across interfaces of care within a region of England?
What are the challenges and potential opportunities for more effective cross-sector working to support medicines optimisation?
We found a range of issues that can reduce patient safety and effective working. For example, major complexity exists in terms of the number of different medicine management systems used throughout the region and challenges relating to incomplete patient records across these systems. A key cause is a lack of interoperability between systems and poor IT and change management. To overcome these issues, this work highlighted how the effectiveness and utility of shared records depend on the data within; therefore, health care and digital leaders must support and encourage the adoption of established and approved digital information standards. There should be minimal system requirements and funding to support the future vision of pharmacy services. Enhanced IT system management across regions may also serve to reduce unnecessary repetition. Importantly, meaningful and continued collaboration with clinical and IT stakeholders to optimize systems and share good practices across care sectors.
Original blog (August 2022):
The digital agenda for pharmacy and medicines optimisation is increasingly complex with communication between the different pharmacy sectors challenging.
This lack of consistent approach led Newcastle University, commissioned by the AHSN NENC and NHS England, to carry out a three month period of research to better understand the current landscape for digital medicines optimisation in the region. The findings of 23 clinical and IT stakeholders are presented within a report written by the University, outlining the challenges and opportunities.
In this blog, Clare Tolley, Lecturer in the School of Pharmacy at Newcastle University, highlights the key findings and recommendations from this research.
People with long term conditions frequently transition between care settings requiring information about a patient’s medicines to be transferred or translated between systems. This process is currently error prone and associated with unintentional changes to medications and miscommunication, which can lead to serious patient consequences. Effective Medicines Optimisation can support individuals to get the maximum benefit from their medicines whilst minimising harm, however access to comprehensive, contemporaneous and accurate and information to inform shared decision making is often lacking. Digital tools can equip healthcare professionals with the right information, at the right time and in the right place to support practice. With several advances in the transformation of services across the NHS, a need was identified to answer the following questions: What examples of systems are being used to transfer information across interfaces of care within the North East and North Cumbria area? And, what are the challenges and potential opportunities for more effective cross-sector working to support medicines optimisation?
A team of researchers at Newcastle University conducted a qualitative study performing in-depth semi-structured interviews with 23 key medicines optimisation and IT stakeholders across the North East and North Cumbria Integrated Care Systems (NENC ICS) between January – March 2022. This work revealed significant complexity in terms of the number of different medicines management systems used throughout the North East and North Cumbria (NENC) region and identified several important challenges around transfer of care issues, centring around having access to incomplete patient records. We also highlighted important barriers relating to the use of digital tools such as: using multiple systems and the impact on workflow, interoperability, digital gaps, IT systems management and change management. Finally, participants described their hopes and opportunities for the provision of medicines optimisation services in the future: there was a clear need for a patient centred consolidated integrated health record for use by all health and care professionals across different sectors, bridging those working in primary, secondary and social care.
The effectiveness and utility of shared records depends on the data within, and therefore local ICS’s must support and strongly encourage adoption of established and approved digital information standards. Further specific priorities around understanding the vision for pharmacy services and supporting this with appropriate funding arrangements and strategic planning of the workforce were also described. In addition, development of minimal system requirements and frameworks, IT system management, to reduce unnecessary repetition, and the meaningful and continued collaboration with clinical and IT stakeholders to optimise systems and share good practice across care sectors, were all identified as key enablers to harnessing the benefits of digital tools to support medicines optimisation in the future.
The report will now be fed into the regional pharmacy and digital forums across the clinical networks and ICS leadership groups to consider how we implement the recommendations and influence future discussions and commissions of digital solutions.
Read the report in full here.