Using standardised data to improve medicines safety and enhance eMAR solutions

Medicines are life-saving – when used correctly, they empower individuals to manage their health and enjoy a better quality of life. The UK spends approximately £17.4 billion on medications annually, which accounts for 10% of the NHS budget. With the rise in long-term conditions and comorbidities, the demand for medications will keep increasing. Moreover, there are over 237 million medication errors every year in prescribing, dispensing, or monitoring medications. The CHUMS (Care Homes’ Use of Medicines Study) report revealed that 70% of care home residents experienced at least one medication error daily. In light of these challenges, it is evident that sharing the right information at the right time with both health professionals and patients is crucial for improving patient safety, enhancing efficiency, and reducing waste and costs.

Digital technology is a key driver of this transformation. Electronic medication administration record systems (eMARs), such as Camascope’s, allow clinicians and pharmacists to accurately track medicine administration, reducing errors and addressing issues such as illegible handwriting and missed entries. This ensures that the correct medication is administered in a timely fashion. In an NHS case study involving 11 care homes using Camascope within the South West London NHS ICB, significant efficiency gains were demonstrated. For example, the time required to order medication decreased from 2 hours to 30 minutes, and weekly phone calls to the pharmacy were reduced from 4 hours to just 5 minutes. Additionally, morning rounds in care homes were shortened from 2 hours to 1.5 hours. These improvements not only lead to substantial cost savings by reducing administrative burdens but also allow staff to dedicate more time to direct, person-centered care. However, it’s essential to recognise that using standardised data is fundamental to harnessing the full benefits of these systems and improving medicine safety on a broader scale – and this is where PRB standards play a vital role.

For example, PRSB’s Community Pharmacy Standard defines the information that should be recorded by the community pharmacy and then shared with GPs, other healthcare services, and the individual. By including clinically relevant outcomes from pharmacy services, the standard aims to enhance medication safety and support medicines optimisation.

Another PRSB standard, the eDischarge Summary Standard enables hospitals to transfer all relevant patient information, including medications, to GP surgeries, care homes and community services upon discharge. This not only supports the continuity and effectiveness of care, but means the individual doesn’t have to repeat their medication information to each professional throughout their care and treatment journey.

eMAR solutions that adhere to PRSB standards are essential for driving the change in effective and safe medicines management, as well as ensuring continuity of care. By combining the advantages of digital technology with the benefits of the standards, these eMAR solutions significantly enhance communication and care co-ordination. Data standardisation enables more seamless integration between eMAR systems and care planning systems, leading to more joined-up care across GPs, pharmacists and hospitals, ultimately improving patient outcomes.

Camascope’s eMAR solution exemplifies how digital innovation can significantly enhance medication safety and streamline care delivery. By leveraging standardised data, Camascope ensures that healthcare professionals have the accurate, timely information they need to provide the best possible care, contributing to safer, more efficient medication management across the healthcare continuum. Looking ahead, Camascope is planning to implement PRSB standards within its system, reinforcing its commitment to improving patient outcomes and ensuring seamless integration across healthcare services.

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Successful teams have the functional skills to lead a task, benefit from diversity, and are led in a way that creates time and space for reflection; the ability to take stock periodically, of the task and of the way in which the team is engaged in delivering it. Your stakeholder analysis [HYPERLINK] should help you assemble the most appropriate team and identify how the team interacts and relates to other stakeholders like sponsors, services users, etc.

The variation in the size, both in terms of population served and numbers of constituent organisations, and of complexity, between Integrated Care Systems, precludes the possibility of any prescriptive guidance on the way in which this team is assembled.

Engeström’s expansive learning cycle of learning actions explains how there are 7 stages of learning actions;

CHAT theory also explicitly addresses five areas which if addressed systematically will help overcome stakeholder differences in pursuit of the common goal:

1. Understanding the artefacts that characterise the group and its activity.
• The artefacts might be clinical settings or the forms and templates used to capture and share information. During the pilot we heard about hard copy Dialog response forms; locally generated templates for collating information from different systems; letters and emails to GPs; images, poems or other non-text artefacts that service users might want to include in their ‘about me’ or care plan.

2. Understanding the multi-views of the group. Such groups are always a community of multiple points of view, traditions and interests. 
• Different participants in the group will have different roles and will bring to the group and their roles their own histories, language, and ‘rules’. During our Stocktake preparations and workshops we worked with psychiatrists, mental health nurses, occupational therapists, social workers, transformation leads and voluntary sector representatives, all professions and interests with their own language, approaches professional ‘rules’ but united in their interest in care plans, care planning.

3. Activity systems (like the ICSs) take shape and get transformed over periods of time. ‘Historicity’ is a term coined to express how the group’s problems and potentials can only be understood against their own history. 

 

• ‘We’ve always done it this way’, ‘that didn’t work before’, ‘it’s always like this’, ‘it wasn’t always like this’, ‘they are changing things again’, are all typical statements that often frustrate those charged with overseeing change initiatives. Without addressing the experiences that lie behind such comments you risk repeating mistakes of the past, alienating your stakeholders or just not understanding the real starting point for your transformation project. This is particularly the case for the implementation of the PCSP standard, the success of which will be largely reliant on point-of-care practices and information protocols as well as having systems which are user friendly and appropriately configured.

4. The central role of contradictions as sources of change and development. Contradictions are not the same as problems or conflicts. Contradictions are historically accumulating structural tensions within and between activity systems. Collectively addressing contradictions in how policy, practice, culture and technology interact will empower teams to find genuinely novel solutions for apparently intractable challenges, like interoperability and shared care plan/planning. 

This links to the fifth principle that:

5. the possibility of expansive transformations in activity systems. As the contradictions of an activity system are aggravated, some individual participants begin to question and deviate from its established norms. In some cases, this escalates into collaborative envisioning and a deliberate collective change effort. “An expansive transformation is accomplished when the object and motive of the activity are re-conceptualised to embrace a radically wider horizon of possibilities than in the previous mode of the activity.”