Electronic prescription Service; Is everyone having problems??

[js421]

My colleagues and I are conducting a research project at the University of Bath on evaluating the implementation of the electronic prescription service in the UK. After collating all the data we have found that there are still some unanswered questions which could only be solved by hearing firsthand the views of practicing community pharmacists.

Firstly, is anyone currently using EPS for repeat dispensing? If so, how does a patient select from a list of their regular medication when submitting a repeat dispensing request at the pharmacy? Can anyone elaborate on how the repeat dispensing process works using EPS and if they find it any better than the current repeat dispensing system?

Secondly, if anyone is currently operating release 2 of EPS (prescriptions arrive electronically at the pharmacy) could you tell us your experiences of the "end of the month" process with regards to submitting prescriptions- does this still occur?

Finally, is anyone currently working in a large pharmacy with several dispensing terminals and only one smartcard? How do you get around this problem?

Thank you so much for your help, it will be greatly appreciated

[johnep]

Never had an EPS script or found anyone that had. Never used the smart card, which took such trouble to obtain. All ever did was to check it on the computer. Connecting for health? What a hideously expensive farce.
johnep

[LeftArm]

Firstly, is anyone currently using EPS for repeat dispensing?

If you mean the "Repeat dispensing service" EPSr1 does not include repeat dispensing AFAIK. The current paper based repeat dispensing system is too complex and doesn't get used very much. EPSr2 includes repeat dispensing. The surgery will upload six electronic scripts at a time that are downloadable when required.

If so, how does a patient select from a list of their regular medication when submitting a repeat dispensing request at the pharmacy?

Patient requests are not part of the EPS service. This is a large omission by CfH. There are currently a number of system suppliers both from Surgery systems and pharmacy systems trying to get some sort of web based repeat request service running. They are variable quality.(Medsrequest,Myrepeats, various surgery and pharmacy web sites)

Can anyone elaborate on how the repeat dispensing process works using EPS and if they find it any better than the current repeat dispensing system?

EPSr2 includes repeat dispensing. The surgery will upload six electronic scripts at a time that are downloadable when required. This should make life easier for patients as they will only need to request scripts every six months. Surgeries will only need to generate scripts every six months. The scripts can be cancelled part way through if required. Dispensers can download the scripts in advance of the patient requiring the item to "manage workload"

Secondly, if anyone is currently operating release 2 of EPS (prescriptions arrive electronically at the pharmacy) could you tell us your experiences of the "end of the month" process with regards to submitting prescriptions- does this still occur?

This is still a bit of a mystery. Currently only a few early implementer sites are running EPSr2. AFAIK Pharmacies will send a "Dispensed Message" when items are supplied but a separate "Reimbursment message" is required for payment to be made. It has been rumoured that these will still be sent as a batch at the end of the month, mimicking the paper system and delaying payment unduly. The NHSBSA (PPA) are still considering a schedule for this.

Finally, is anyone currently working in a large pharmacy with several dispensing terminals and only one smartcard? How do you get around this problem?

A smartcard is only required for access to the data spine to download prescription messages and upload Dispensed and reimbursment messages. One terminal can be used for this with a smartcard while the scripts can be processed on a separate terminal.

[Pharmanaut]

This is still a bit of a mystery. Currently only a few early implementer sites are running EPSr2. AFAIK Pharmacies will send a "Dispensed Message" when items are supplied but a separate "Reimbursment message" is required for payment to be made. It has been rumoured that these will still be sent as a batch at the end of the month, mimicking the paper system and delaying payment unduly. The NHSBSA (PPA) are still considering a schedule for this.

Thought that you could send reimbursement messages individually or as batches when you want to.
There will be a reluctance to let these messages go at first as they are kind of final... whereas you can always scribble on a paper script until the box leaves the pharmacy. In other words you have to be confident that you haven't missed something, such as OOP, NCSO, M/F etc otherwise you lose allowances.

Surely suddenly everyone sending thousands of messages last minute will spike bandwidth and overload the spine.
Agree there is some weird formula about what can be included in the 'previous month'.

[LeftArm]

An obvious benefit for dispensing contractors for EPS would be prompt and accurate payment by the NHSBSA but this was not considered in the specification.

http://www.connectingforhealth.nhs.u...ess/submission

Can a reimbursement message be sent at the same time as a dispense notification?No, a reimbursement endorsement message can only be submitted once the dispense notification message has been sent. The dispense notification message informs the EPS which medication has/has not been
supplied to the patient.
A schedule will be issued for pharmacists to follow as to when to submit the
electronic reimbursement endorsement message.

[Pharmanaut]

An obvious benefit for dispensing contractors for EPS would be prompt and accurate payment by the NHSBSA but this was not considered in the specification.

http://www.connectingforhealth.nhs.u...ess/submission

yes quite, but once the notification has been sent, the claim message can surely be sent.
Do they really have to be queued up for transmission all at the same time?

[onlinepharmacyguru]

I really like it's batch prescirption scan facility. Scan 5-10 prescription at a time and review one by one on screen. Sometime really difficult part is to scan prescription Barcode. Have you experience that yet?

[LeftArm]

I really like it's batch prescirption scan facility. Scan 5-10 prescription at a time and review one by one on screen. Sometime really difficult part is to scan prescription Barcode. Have you experience that yet?

It's not really a time saver though as you still have to find the script in the list after you have downloaded it. Release two will resolve this as the message is the prescription and they will be downloaded in batches. Some sort of picking ticket will still be required.

Is it a snow day for you Mr. onlinepharmacyguru?

[bobbin]

An obvious benefit for dispensing contractors for EPS would be prompt and accurate payment by the NHSBSA but this was not considered in the specification.

There will be new problems, unfortunately. Any product-related information written by the doctor in the dosage instructions section will be ignored.

For example:

Emulsifying ointment BP
(with coal tar 2% - apply as directed)
500g

.......would be reimbursed at the DT price for emulsifying ointment. The bit about coal tar would be ignored because it was included in the dosage instructions box. Same problem will apply when doctors add things like 'sugar free' and 'mixed flavours' in the dose box. All will be ignored.

[Pharmanaut]

There will be new problems, unfortunately. Any product-related information written by the doctor in the dosage instructions section will be ignored.

For example:

Emulsifying ointment BP
(with coal tar 2% - apply as directed)
500g

.......would be reimbursed at the DT price for emulsifying ointment. The bit about coal tar would be ignored because it was included in the dosage instructions box. Same problem will apply when doctors add things like 'sugar free' and 'mixed flavours' in the dose box. All will be ignored.

So script will need to be 'Bounced' and request by phone to send script as paper or release 1.
In the meantime - what is that pharmacist doing, just gimmee the damn medicine - he's a jobsworth.

Appears to be no mechanism for getting round this in the 'real world'.