STRATEGIC OUTLINE CASE PHARMACY STOCK CONTROL PROJECT DOCUMENTATION. Release: Draft vs Date: 6th June 2008

Transcription

1 PROJECT DOCUMENTATION STRATEGIC OUTLINE CASE PHARMACY STOCK CONTROL Release: Draft vs. 0.5 Date: 6th June 2008 Author: Liz Boylan Noy Scott House RDEH(Wonford) Barrack Road Exeter EX2 5DW Tel: E/mail: 6th June 2008 v0.5 Page 1 of 7

2 strategic outline case STRATEGIC CONTEXT NATIONAL CONTEXT ORGANISATIONAL CONTEXT THE CASE FOR CHANGE EXISTING ARRANGEMENTS SYSTEM SPECIFICATION OPTIONS ESTIMATED COSTS IMPLEMENTATION TIMETABLE RECOMMENDATIONS...7 6th June 2008 v0.5 Page 2 of 7

3 STRATEGIC OUTLINE CASE 1. STRATEGIC CONTEXT The RDEFT pharmacy department provides a comprehensive, safe and timely range of prioritised medicines management services that meet the needs of the patient, wards and the Trust. It is known that prescribing, drug administration and medicines management is the most common active intervention made with patients. It is associated with significant risk from adverse events, prescribing and drug administration errors. Every effort is made to develop and maintain a pharmacy service that maximises the benefit and minimises the associated risks. Inevitably the resources allocated are finite and provision is appropriately prioritised and managed. With ever increasing pressure to contain health costs and improve outcomes an IT system is required that will provide clinical and administrative support to prescribers, pharmacists and nurses throughout the medicines process. Comprehensive integrated facilities using the most up-to-date technology will need to provide for drug ordering, stock control, ward stock top-up including direct ward delivery, dispensing, labelling, aseptics prescribing with clinical decision support and administering to patients. The objectives of this investment case are: to define the options for delivering a replacement pharmacy stock control system that can be linked with e-prescribing and interface with a pharmacy robotics stock selection system and will meet the objectives for acute patients in the Exeter, East and Mid Devon health and social care community; to assess the costs and benefits associated with each option; and to identify a preferred option. The estimated cost of the proposed investment will be approximately 234.7k in 2008/09 with recurring revenue costs of 24.3k, reducing the current revenue costs of 32.3k by at least 8k per annum. 2. NATIONAL CONTEXT 2.1 The proposed investment is aimed at contributing to improvements in the provision of health and healthcare services for the local population. However, it takes place in the context of developments in national health policy and associated strategies and plans. In some cases these have a direct bearing on local plans, directing or constraining the choices at local level; this is most clearly the case with national policy, strategy and plans for information and information technology. Examples include the national strategy set out in Information for Health and the various infrastructure projects and other IM&T initiatives 6th June 2008 v0.5 Page 3 of 7

4 3. ORGANISATIONAL CONTEXT 3.1 Existing service provision Table 1: Pharmacy Workload / Staffing Levels Section Workload (2007/08) Staffing WTE (2007/08) Dispensary 283,000 items 3 pharmacists, 4 technicians, 6 SATOs Stock Distribution Aseptic Services Medicines Information Procurement 244,000 items 1.5 technicians, 7.5 ATO s 24,000 items comprised of 17,500 cytotoxics, 6,500 other aseptic products 4 pharmacists, 10 technicians, 1 ATO 2,200 enquiries 1 pharmacist 14,200 orders, 26,000 invoices to value of 20,590,000 drug purchases 3.0 staff Clinical Trials 60 clinical trials 0.8 senior technician, 0.54 technician, 0.5 SATO Clinical Pharmacy Medicines Management Increasing number of wards (17 at 31 st March 2008) have a Patient s Own Drug scheme (PODs). 1 principal pharmacist, 7 senior pharmacists, + rotational basic grade pharmacists. 5 technicians. 4. THE CASE FOR CHANGE 4.1 The RDEFT Pharmacy Department recognises the need for change in the way IM&T is deployed in support of its staff and patients. To this end it has determined that it should seek to invest in improving its IM&T provision through the implementation a modern stock management system that will support the delivery of better clinical care. 4.2 The following sections describe in more detail: Existing system provision Specification of system requirements Solution and supplier options. 6th June 2008 v0.5 Page 4 of 7

5 5. EXISTING ARRANGEMENTS 5.1 The existing EDS Pharmacy Stock Control system was installed There is considerable uncertainty surrounding future support for EDS systems within the South West and as individual organisations procure alternative solutions indications are that support costs will increase considerably and future development will be very restricted. Although there are suggestions that EDS are considering a whole system rewrite that would also include e-prescribing, no timeframe has yet been suggested. In addition there is, at present, no interface to an e-prescribing system should it be implemented across the RDEFT. 6. SYSTEM SPECIFICATION 6.1 The RDEFT Pharmacy Stock Control solution will include modules that provide automated ordering and delivery, with associated invoice and credit handling; through to patient supply via ward stock issues and dispensing. 6.2 Basic Pharmacy Stock Control configuration should include:- Stock Handling Order and Delivery Processing Invoice and Credit Handling Dispensing incorporating individual patient supplies, one-stop and over labelling of patient s own drugs, ward stock issues, controlled drugs register, extemporaneous dispensing and formulary management Manufacturing and Trading Account Parenteral Nutrition Manufacturing Information Management incorporating basic standard reports and Ad hoc reports External Interface to Patient Administration System (PAS) Interface 6.3 Additional Application Modules and Interfaces CIVAS and CYTO s Manufacturing Module should support the production of patient based CIVAS and Cytotoxic injectable products. The module should provide stock control of the raw materials and finished products, support for the production process and appropriate interface to the CIS Oncology prescribing system. An Accounts Payable Interface should provide a bespoke summary of invoices processed for payment. A General Ledger Interface should provide a bespoke summary of issues made to cost centres. A Dispensing Robot Interface should send an HL7 message to a robotic device to enable the picking of a container as part of the dispensing process. The Dispensing interface is a prerequisite for all other ADR interfaces. A Bulk Issues Robot Interface should send an HL7 message to a robotic device to enable the picking of a container as part of the ward stock supply process. A Requisitioning Interface should enable the Robot to pick stock to supply other locations with stock. 6th June 2008 v0.5 Page 5 of 7

6 A Robotic Delivery Interface should facilitate the goods receipt of medicines through bar-coding, updating the stock levels on both the robot and the System through a single process. A Prescription Discharge Module should support the generation of an interim discharge letter incorporating the active medicines profile for the patient and drugs required for dispensing at discharge. The discharge function should offer the prescriber an intuitive and simple way to choose the medicines for the patient to take home in addition to dictating the quantity to supply and indicate whether the GP should continue treatment. 7. OPTIONS 7.1 Solution Options The RDEFT preferred solution must embrace a replacement for the existing stock control system and provide the facility to interface/integrate with any future implementation of e-prescribing at the RDEFT. The following options have been considered: Option Solution Positives Negatives 1 Maintain existing EDS system 2 Procure a new stock control system 3 Procure integrated package for e- prescribing, stock management and administration Known system. Interfaces with robot Modern up to date system that will interface to e- prescribing and robot Modern fully integrated system Uncertainty re future support Restricted future development No present interface to e-prescribing Additional costs and potential issues associated with interfacing different systems Option 3 is the preferred option. An integrated system would provide a seamless information system for the provision of pharmacy services across the Trust. A phased implementation of stock management followed by e-prescribing would be the chosen method of approach. The procurement and implementation of the e- prescribing modules is covered by a separate Business Case. 7.2 Supplier Options The Pharmacy Department has identified two major suppliers of pharmacy systems who can meet the specification required and have also been approved as part of the Connecting for Health evaluation for additional services. These are JAC Computer Services and Ascribe plc who will be invited to tender for the required solution. 6th June 2008 v0.5 Page 6 of 7

7 8. ESTIMATED COSTS 8.1 For the purposes of this SOC budgetary costs obtained from one of the LSP approved Pharmacy solution providers are set out below: System Supplier Costs Capital inc VAT Revenue inc VAT Standard Pharmacy Stock Control System for 35 concurrent users, training and implementation 104,845 12,537 Civas & Cyto modules and training 13,618 2,115 Financial Interfaces 11,750 1,058 Robot Interfaces 22,031 4,024 Prescription Discharge 35,015 4,583 Subtotal 187,260 24,317 RDEFT Implementation Costs 12,220 Project Management (6/12 x 0.4 wte) Data Migration (4/12 x 2 wte) 23,500 Implementation (6/12 x 0.5 wte) 11,750 Subtotal 47,470 Total Expenditure 234,730 24, IMPLEMENTATION TIMETABLE 9.1 A full project plan will be developed with the chosen supplier. It is anticipated that implementation could commence in September 2008 with completion by March RECOMMENDATIONS 10.1 The RDEFT Pharmacy Department recommends the procurement of a replacement stock control system that will ensure the continuation of a comprehensive, safe and timely range of prioritised medicines management services that meet the needs of the patient, wards and the Trust. This procurement must also provide the future interface/integration to an automated dispensary management (robotic) and an e- prescribing system that will support services across the Trust. 6th June 2008 v0.5 Page 7 of 7