Electronic Prescribing (ePMA)

This page is about our ePMA project - Electronic Prescribing and Medicines Administration.

What are the issues with the current prescribing systems?

  • Illegible hand writing on prescriptions and charts
  • Incomplete information being recorded on an order
  • In-appropriate ordering
  • Transcription errors
  • Lost or misplaced drug charts
  • Physically transferring the order from wards to dispensaries is not timely
  • Error in calculations for specific medicine doses

The NPSA have calculated the cost of medication incidents nationally to be £750m. The EQUIP study (2009) identified a prescribing error rate in secondary care of 8.9%, and NICE guidance highlighted up to 70% of patients have at least one error in their initial prescription when admitted to hospital.

What will the new EPMA include?

EPMA systems are specifically designed to reduce the risks associated with traditional methods of prescribing and administering medicines.

The new EPMA will include:

  • Electronic generation of the prescription

  • Electronic recording of medicines administration
  • Full record of all medicines prescribed and administered held within the electronic patient record (EPR)
  • Electronic transmission of medicine supply requests to Pharmacy (once interoperability has been established)
  • Access to the system for prescribing for in-patient, out-patient and ability to view prescribing occurring in primary care e.g. GPs

What are some of the main benefits to be gained from an EPMA system?

The greatest benefits to be derived from implementing an EPMA system are those related to improving the safe provision of care to patients. EPMA achieves this through:

  • Mandated fields to capture allergies and sensitivities
  • Pre-populated order sets
  • Promotion of our Medicines Formulary
  • Alert functionality for patient – drug interaction
  • Reduction in the need to transcribe
  • Medicines started, stopped and changed during admission captured in the discharge prescription
  • Electronic access to GP records
  • Clear audit trail in terms of identifying prescriber, administrator, checker rather than determining illegible signatures
  • More timely supply of medicines facilitated by electronic ordering on the ward and transmission to Pharmacy
  • Alert system for missed / late doses
  • Legible prescription and doses, with no crossing out
  • Mandated fields when manually generating an order set to ensure all minimum prescription data entered
  • Medicine database with alert functionality for drug – allergy and drug – drug interactions
  • Ability to restrict prescribing access to certain drugs
  • Elimination of the use of inappropriate decimal points, abbreviations and unit measures
  • Alert system to highlight ‘critical medicines’ to ensure timely administration
  • Automated reports to provide accurate data highlighting issues with aspects of medicines management

How can I learn more?

Training is available for medics, medical secretaries and non-medical prescribers, and will be made available to inpatient nurses.

Following the training, you can brush up on your skills by:

How can I get involved with the EPMA implementation?

  • Crisis Teams ePMA Working Group – Mondays at 2pm-3pm (fortnightly)
  • Inpatients ePMA Working Group – Thursdays at 3pm-4pm fortnightly 
  • Community Teams ePMA Working Group (OA and WAA) – Wednesdays at 3.30pm-4.30pm (fortnightly)
  • CAMHS and ANS (Adult Neurodevelopmental Services) ePMA – the roll-out of the system has been completed, and services can access support via the Arden and GEM IT Service Desk 

If you are interested in joining one of the ePMA working groups listed above, or would like more information, please contact the EPMA project team: dhcft.businesschange@nhs.net