Digital health technology is transformative - helping to deliver better patient care while supporting clinicians. One of the great examples that we have seen emerge more and more over the last 18 months is Electronic Prescribing, a vital element of digital healthcare - a form of paperless prescribing that is reported to reduce prescription mistakes and increase cost effectiveness. Recent research from The King’s Fund paper ‘Shaping the future of digital technology in health and social care’ recognises electronic prescribing as: ‘Systems like electronic records, e-prescribing, automated observations and clinical communication apps are developed, adapted and adopted by providers in most settings across the country. Together, they help clinicians treat people more safely and efficiently, with a low administrative burden.’'[1] These are wise words and support the theory of the transformative powers of digital healthcare.
In this blog, we’re going to focus on Electronic Prescribing and the Electronic Prescription Service (EPS) and drill down into their benefits and where these innovations sit in the digital health technology landscape.
Electronic prescribing pre- and post-COVID
Many people are talking about the effect of COVID-19 on accelerating the continued uptake of digital health, and since the beginning of the pandemic, there have been successful and rapid roll outs of digital healthcare solutions, boosted by an urgent need to treat patients in different ways, under difficult conditions.
Electronic Prescribing is developing rapidly in our current climate, as it’s required more widely and much more quickly. Software companies want to make the prescribing process safer, quicker and more efficient, meaning that time is freed up for clinicians to spend delivering more efficient patient care. Prescribers want flexibility and don’t want to go back to the ‘bad old days’ of large-scale Electronic Prescribing projects, where people operated in silos and cumbersome systems took years to implement.
The national roll out of the Electronic Prescription Service (EPS)[2] launched in 2017 and meant that prescriptions could be sent directly from GP practices to a community pharmacy - electronically rather than on paper. This will eventually remove the need for most paper prescriptions, and, at the time, the NHS predicted that it would save them over £300 million by 2021.
For core primary care services, the introduction of EPS was a welcome step-change in the delivery of efficient patient care, but with COVID-19, one of its emerging legacies has been the amazing progress on Electronic Prescribing solutions –– with the need to develop new solutions to meet previously unidentified requirements. Clinical system suppliers were given the chance to rapidly roll out or tweak solutions to combat COVID-19 and the overall feedback from the industry – and citizens - has been positive, in terms of the adaptability and flexibility of solutions.
Why is EPS such a transformative tool?
Electronic Prescribing can transform ways of working for clinicians, as well as bringing safety benefits to patients. It also brings a positive environmental impact, meaning that clinicians reduce their use of paper and provide a more efficient service to patients. It’s more convenient for patients as they can collect prescriptions from the pharmacy most local to them - be it at their GP, Out of Hours, Urgent Treatment Centre or other out-of-hospital setting and won't have a paper prescription to lose.
Urgent Care settings have been using Electronic Prescribing since a successful trial and roll out in 2018/19[3] and whilst at the time it was a positive step forward to improve the patient pathway, the impact of COVID-19 on both the wider adoption of EPS and the recognition that EPS has a place in other care settings has been widely recognised.
It has increased efficiencies across the NHS, and will continue to do so, by:
- eliminating the need for patients to pick up repeat prescriptions from their GP
- allowing prescribers to digitally sign and cancel electronic prescriptions, rather than using a physical signature
- reducing the amount of administration needed around prescriptions, and reducing the volume of prescriptions that need to be stored
How have requirements changed and attitudes been adapted to recognise the benefits of EPS?
One particular area that has recently been highlighted is the need for non-face-to-face prescribing capabilities. This is one of the effects of the pandemic – as prescribers were not necessarily seeing their patients in person. This has been recognised by the Royal College of Nursing (RCN) and their ‘Prescribing safely under COVID-19’[4] sets out guidance for nurses who are being asked to treat patients remotely via video or telephone.
Which other settings could benefit from EPS?
We’ve had a look at where EPS has been introduced – but it’s not just primary and urgent care clinicians that want to be able to perform electronic prescribing quickly. There are other areas which would benefit hugely from the ability to carry out Electronic Prescribing, including acute and dental services.
One thing we’ve learned is that you cannot operate in silos when delivering digital technology and interoperability is vital. Interoperability doesn’t need to be a slow burn or difficult to bring together. There are solutions out there that are easier to implement. Integration and working with other systems’ providers can be easily achieved with the right dedicated delivery team. There are even options for systems to be delivered quickly and that can be delivered in a stand-alone way to suit an immediate need and do not necessarily require integration. [5]
The recent King’s Fund paper ‘Shaping the future of digital technology in health and social care’[6] started before the pandemic, but was completed in April 2021 – and states: ‘The COVID-19 pandemic has created a huge set of pressures on the system while it is undergoing a significant transformation – with the establishment of integrated care systems (ICSs) as statutory bodies over the next 12 months marking a fundamental change to how health and care organisations make decisions and exchange information.’[7] So, now is a time of great change and challenge – but also a time for opportunities – and making the most of the excellent solutions which are available.
[1] www.kingsfund.org.uk/sites/default/files/2021-04/Shaping%20the%20future%20of%20digital%20technology%20in%20health%20and%20social%20care.pdf
[2] https://digital.nhs.uk/services/electronic-prescription-service
[3] https://pharmaceutical-journal.com/article/news/electronic-prescribing-to-be-rolled-out-across-urgent-care-settings-in-england
[4] https://www.rcn.org.uk/clinical-topics/medicines-management/covid-19-remote-prescribing
[5] www.ic24.org.uk/news/ic24-introduces-electronic-prescribing/
[6] www.kingsfund.org.uk/sites/default/files/2021-04/Shaping%20the%20future%20of%20digital%20technology%20in%20health%20and%20social%20care.pdf
[7] www.kingsfund.org.uk/sites/default/files/2021-04/Shaping%20the%20future%20of%20digital%20technology%20in%20health%20and%20social%20care.pdf