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Client Story

An integrated pharmacy dispensing pathway at Bolton NHS Foundation Trust

In October 2019, Bolton NHS Foundation Trust became the first NHS trust to integrate Altera Digital Health’s Sunrise EPR with EMIS Ascribe pharmacy dispensing system. The integration aimed to eliminate the need for manual transcription of electronically prescribed medications from Sunrise to the pharmacy system—in turn managing inherent risks associated with this process.

Many trusts do not have an interface in place, and, despite having an EPR, must manually transcribe prescriptions between the EPR and pharmacy systems. The new digital dispensing pathway for inpatients has transformed their prescribing processes, improving patient experience and patient safety as well as patient flow.

Eliminating transcription risks

Prior to October 2019, before the trust launched Sunrise EPR, all medications
were prescribed on paper. Inpatient medications were prescribed on paper
drug charts and outpatient prescriptions were prescribed on paper forms.

The integration was engineered during the development and configuration
stages of the trust’s Sunrise EPR system activation, ensuring seamless
functionality upon its launch in October 2019. The interface was continuously
tested, maintained, and improved to achieve optimal efficiency. Rigorous
testing required end-to-end simulation of prescribing workflows to include clinical checks, supply requesting and discontinuing medications electronically. These tests were repeated in multiple permutations against the
entire drug catalogue to ensure accurate transfer of prescription details across the interface.

Faster medication administration
Enhanced patient experience
Improved patient safety
graphical representation of a person inside a process circle.
Better patient flow

Timely medication

Since ePrescribing and the interface went live, inpatients can receive their
medications sooner. With this interface, the drug chart is always available
and there is no delay in the pharmacy receiving the request for drugs to
be dispensed. Because of this, there is a reduced time before the drugs are
available to administer to the patient.

The electronic system allows staff to order items at any time of the day/night
without having to contact pharmacy. Because the chart is electronic, there is no longer the need for pharmacy staff to be physically on the ward to be able to check the chart and request the item to be dispensed from pharmacy.

By doing this, there are fewer late or missed doses and far less transportation
of drug charts by both porters and clinical staff, releasing time for these staff
members. Ward staff chasing drug charts not only led to delays and omissions of drug administration to patients but also took busy staff off the ward. If a patient required urgent medication, for example, pain control whilst their drug chart was in pharmacy, this, too, meant they would have to wait until the drug chart was returned before pain medication could be administered.

“The integration of Altera’s Sunrise EPR with EMIS Ascribe Pharmacy dispensing system at the trust has been transformational. It has not only streamlined medication management but also demonstrates our trust’s commitment to patient safety and operational efficiency.”

Kyle Cromey
Chief Pharmacy Information Officer

For patients who suffer from long-term conditions such as Parkinson’s disease or diabetes, timely administration of medications is crucial to the control of their condition, and delays in drug dispensing or delays in drug administration whilst the drug chart was off the ward can exacerbate significant symptoms and could delay their recovery, it could even result in a prolonged stay. These delays due to drug chart unavailability are now a thing of the past.

The benefits of the interface have compounded and amplified the overall
benefits the trust experienced with the simultaneous activation of electronic
prescribing within Sunrise EPR. This is enhancing patient safety and efficiency

  • More accurate, legible prescribing
  • Embedded clinical decision support to minimise prescribing errors, drug
    interactions and potential allergic responses
  • Better adherence to local formulary guidance and protocols
  • Improved workflow and management of admission and discharge medication reconciliation
  • Ability for staff to prescribe without visiting the patient’s location—enabling urgent prescriptions to be administered without delay
  • Pharmacy verification and checks can occur more quickly without pharmacy staff visiting the patient’s location
  • Significantly reduced delays caused by unavailable drug charts
  • Mitigating the need to re-prescribe the entire drug chart once it is “full up” when patients have an extended stay
  • Safe and accurate conversion of inpatient medication to discharge medications
  • Reduction in the need to transcribe

Kyle Cromey, Chief Pharmacy Information Officer commented, “The integration of Altera’s Sunrise EPR with EMIS Ascribe Pharmacy dispensing system at the trust has been transformational. It has not only streamlined medication management but also demonstrates our trust’s commitment to patient safety and operational efficiency.”

The future

Working collaboratively, we are always improving the system, maintaining an
open dialogue around what works and what doesn’t. In 2024, the trust will
extend the pharmacy system integration to include outpatient prescriptions,
enabling a comprehensive and unified approach to medication management
across all patient interactions and reducing patients’ waiting times whilst their
medications are dispensed.

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