Andrew Davies is a Fellow of the Faculty of Clinical Informatics and has been involved with medicines-related data throughout his professional life, ranging from managing pharmacy medicines stock management systems to becoming a chief pharmacist. As part of the Lord Carter Hospital Pharmacy Transformation Programme (HPTP), Andrew assumed the position of Medicines Data Lead, designing the Model Hospital pharmacy and medicines metrics, and he is now Operational Productivity Director of Hospital Pharmacy at NHS Improvement.
Joining the Faculty of Clinical Informatics, along with a growing number of other pharmacy professionals, has been an important step, from my perspective. Medicines data, within NHS providers, is an interesting challenge for the ‘data wonks’ of the world! Historical systems and processes have led to fragmented data sets, with poor interoperability and limited comparability, from an analytical perspective.
There is currently no mandated central data collection or repository for data on the medicines used in hospitals (unlike there is in primary care). A number of commercial systems are used, however, these systems do not provide patient-level analytics, as the most common intervention in healthcare, and the largest NHS spend after staff, is the use of medicines. At an estimated £18.2billion, it is essential that systems and processes are developed to allow data-driven care to be used to optimise the use of medicines.
To get to patient-level medicines usage data linked to diagnosis and outcomes, it is essential that hospitals implement Electronic Prescribing and Medicines Administration (EPMA) and that it is interoperable with other clinical systems. In 2018, only 30% of acute trusts had fully implemented in-patient EPMA. As a result of this limited progress, £75million is being invested to accelerate the rollout of these systems into provider organisations.
To truly optimise the use of medicines, a cultural change in how pharmacy professionals view their roles and skills is needed for understanding the science of clinical informatics. It is not just volumes of medicines, costs, or key performance indicators as to speed or safety of supply, but true medicines optimisation which requires structured data systems, to allow the capture, analysis and clinical use of patient-level informatics.
This will enable the connection of:
- prescribing information – diagnosis and indication for a medicine;
- product and supply information;
- outcomes from the use of medicine, in terms of patient benefit and health gain;
- support for research into medicines, clinical use, and impact on patients
patient factors, including concordance and any potential harms;
- costs, clinical choice, and efficiency of supplied medicines.
To support the pharmacy profession in understanding the changes needed in its regulation, educational systems, professional development, and peer support, I had the privilege to Chair the development of a review into data-driven care. It’s clear there are parallels in other clinical professional groups and, with the support of the Faculty, the interoperability of professionals and data will significantly improve patient care.