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Integrating Patient Care
Blackpool Teaching Hospitals NHS Foundation Trust
Project Overview
What has been the impact?
Why select Ascribe Consulting?
• Blackpool Teaching Hospitals NHS
Foundation Trust required integration
between their Ascribe Pharmacy
system and their ALERT® ePrescribing
(ePMA) and Electronic Healthcare
Record (EHR) system to improve
patient care.
• The Integration scoping project
helped the Trust understand the
operational impact of integrated
systems.
• Ascribe Consulting has over 15
years expertise with NHS integration.
• To ensure the requirements were
translated into a safe and effective
end-to-end design for this critical
integration project, the Trust engaged
Ascribe Consulting to deliver a
scoping project.
• Ascribe’s approach provided a
framework for all three parties
(Ascribe, ALERT and Blackpool) to
determine a clear and shared
definition of process requirements,
and agree the architecture and
standards based design.
• The Ascribe Consulting team engaged
with end users to review the design
and ensure that the project supported
the needs of the hospital.
• The integration project will support
the Trust’s vision in delivering the
benefits of ePMA.
• By providing a clear scope and high
level design for the integration, the
Trust was able to establish clear
criteria and apportion responsibilities
and roles across the two systems
suppliers.
• The design will help to control drug
spend for the hospital by allowing the
dispensary to continue to choose the
most cost-effective dispensing option.
• The best features of each system
have been harnessed with no loss of
functionality.
• The project will provide instant,
accurate transmission of the
prescription information making
the Pharmacy team more efficient
and improving patient safety by
removing the risk of errors on
transcription of prescriptions.
• Ascribe delivers enterprise class
integration platforms and solutions
that automate data integration
between systems within an efficient
process that reduces costs and
improves patient care.
• Ascribe’s consultants use a proven
integration method that starts with
the workflows and focuses on driving
benefits through process improvement.
• We design and deliver highly
scalable Integration Engine
platforms that provide future and
disaster proof solutions, across a
wide range of platforms, including:
Microsoft BizTalk®, InterSystems
Ensemble® and MirthTM and a
range of offerings from Orion® and
Sun Microsystems.
• Ascribe has been awarded Microsoft’s
Health Partner of the Year 2012.
www.ascribe.com
Integration:
Tailored to the Trust
Introduction
The Blackpool, Fylde and Wyre Hospitals
NHS Foundation Trust (“the Trust”)
was established on 1st December
2007. The Trust then gained teaching
hospital status and became Blackpool
Teaching Hospitals NHS Foundation
Trust in 2010. In April 2012 the Trust
merged with community health services
from NHS Blackpool and NHS North
Lancashire as part of the Transformation
of Patient Pathways Programme.
The Trust now serves a population of
approximately 440,000 residents
across Blackpool, Fylde, Wyre and
North Lancashire. They employ over
6,000 staff, have around 830 beds
across all sites and see more than
56,000 daycase and inpatients,
250,000 outpatients and over 91,000
A&E patients every year.
Project Background
Blackpool Teaching Hospitals NHS
Foundation Trust (“Blackpool”) is
working with ALERT® to implement
an Electronic Healthcare Record
(EHR) system across the Trust.
The EHR programme is branded
as the “Vision programme.
Process and workflow
requirements
C
Ascribe’s integration strategy supports
integration across Ascribe and third
party solutions.
At Blackpool, there were no standard
Ascribe interfaces in place between
the installed solutions, this is not
uncommon as Trust requirements can
be highly specialised and specific.
In order to scope out the requirements
for an integrated interface, Ascribe
Consulting engaged with the Trust and
ALERT to cover four key areas:
1. Process and Workflow requirements
2. Reference Data – especially
Drug Databases
3. Technical Architecture
4. Project plan
for implementation
Ascribe
Consulting
e
The first task was to achieve a clear
definition of process requirements,
and how they would be underpinned
by the integration solution.
There is no substitute to engaging
with clinicians and talking through
their working processes. A number
of workshops were held at the Trust
(including members of staff from the
Pharmacy department) to work through
the process and workflow implications
of
P the integration. Ascribe used this
information to map the trigger points
for messages.
These sessions identified a key issue
of great importance to the clinicians,
namely, the importance of strength
switching (and similar flexibility at the
dispensing stage) in order to use stock
effectively and reduce drug costs. The
ALERT ePMA solution would not support
this function, so it became an important
aspect of the integration design to
allow Trust staff this flexibility.
t
The Trust also have Ascribe Pharmacy
installed, and there was a requirement
for integration between the two
systems, in order to support efficient
and safe patient care.
The Trust engaged with Ascribe
Consulting to determine how Integration
could be applied to these solutions
and ensure that the business and
patient care requirements were
translated into a safe and effective
end-to-end design.
“
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www.ascribe.com
Ascribe’s process-led method and
integration experts helped us to
think through the operational
impacts and make the right design
decisions for the Trust
Craig Tilley, Lead Pharmacist at
Blackpool Teaching Hospitals NHS
”
The dm+d concept (source: PSNC)
Reference Data: Drug
Database Considerations
One of the key deliverables of the
scoping study was to ensure that
medication information could be
coded and safely transmitted (and
understood) by both the Ascribe
and ALERT systems.
For a working interface, the drug files
between ALERT and Ascribe would
need to be mapped and tested to
cover the Trust’s hospital-wide list.
It was agreed between all parties that
the coding of the drug database would
be based upon the NHS dictionary of
medicines and devices (“dm+d”); this
is the acknowledged NHS standard for
communicating medicines information
between clinical systems.
However, it was also recognised that
dm+d is Primary Care focussed, and
would currently cover around 80% of
medications prescribed in Secondary
Care. It was agreed between the parties
that local codes would be needed in
order to cover the remaining 20%.
The maintenance of the drug file
between the two systems is a vital
consideration, as the drug file in use
at the hospital is not static. The team
ran workshops to discuss and agree
the process for managing changes
in order to ensure that procedures
could be defined to safely update
both systems.
Technical Architecture
Ascribe carried out detailed discussions
with Blackpool and ALERT to ensure
an agreed platform was designed to
support the interface communications.
Blackpool already had a Trust Integration
Engine (TIE), but Ascribe’s work
helped identify potential risks, such
as the impact of a loss of one or more
of the platforms in the interface chain.
The critical nature of this integration
meant the Trust needed to review
their required service levels and
Business Continuity plans. The
architecture work ensured that all
components would be brought up to a
minimum agreed level of robustness,
and (alert) enabled for all aspects of
the process.
Project plan for
implementation
The final part of the scoping exercise
was to create a plan for implementation.
This exercise involved all parties
clearly defining each of their
deliverables and a realistic timetable
of activities to be undertaken.
This work also enabled everyone to
be clear on what could and could not
be delivered within the scope, setting
realistic expectations and transparency
between Ascribe, ALERT and Blackpool.
A Pragmatic Partnership approach
Craig Tilley
“The work that has been done to date
in order to develop and design the
integrated interface, has been due to
an effective partnership approach
between ALERT, Ascribe and the Trust.
Ascribe Consulting have helped the
Trust to engage on the project
through various workshops and there
has been good representation from
Ascribe Pharmacy colleagues at the
workshops which has enabled strong
discussions around operational impacts,
limitations and reviews of all service
levels and business continuity.
There is a great team at Blackpool,
a lot of clinicians, pharmacists and
technical staff that have been involved
and worked together with Ascribe
and ALERT.
It’s of great credit to the team including
Ascribe that they have embraced and
engaged with the project to get the
best outcome for the integration
project.
Ascribe’s process-led method and
integration experts helped us to think
through the operational impacts and
make the right design decisions for
the Trust.”
Credits
Our thanks to Craig Tilley, Lead
Pharmacist, Electronic Prescribing and
Medicines Administration at Blackpool
for his contribution to this document
and presenting on the integration
project at the 2012 Ascribe User
Conference.
Copyright 2013 - Ascribe Ltd.
Benefits
IT
Clinicians
Management Executives
Clinical 5 expertise and experience
and HL7, DICOM, EDIFACT and
Interoperability Toolkit (ITK) experts.
Improves patient safety by
integrating clinical systems,
reducing errors between systems
and improving clinical and
administrative processes.
Significant cost savings through
process efficiency with reduced
administration effort.
Up to 24x7 flexible packages for
Solution Monitoring, Management
and Support.
Clinical Process and Integration
UAT support.
Design and delivery of highly
scalable Integration Engine
platforms across a range of
technology choices, including
InterSystems Ensemble®,
MirthTM, Microsoft BizTalk®
and others.
Ascribe Ltd.
Ascribe House
Brancker Street
Westhoughton
Bolton BL5 3JD
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Email
Provides a consolidated view of
clinical data from multiple sources
to support better decision making
Share information with other
partners to support the patient’s
care pathway
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[email protected]
Solutions designed to allow for on
going business change, changes to
clinical systems and on going
improvement to clinical processes.
Single point of call for all aspects
of project delivery.
Confidence in measurable outcomes.
Ascribe IPC March 2014

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