JMIR Publications

ABSTRACT

Background:

People with long term conditions frequently transition between care settings requiring information about a patient’s medicines to be transferred or translated between systems. This process is currently error prone and associated with unintentional changes to medications and miscommunication, which can lead to serious patient consequences. Digital tools can equip healthcare professionals with the right information, at the right time and in the right place to support practice.

Objective:

With several advances in the transformation of services across the NHS, a need was identified to answer the following questions: what examples of systems are being used to transfer information across interfaces of care within a region of England? And, what are the challenges and potential opportunities for more effective cross-sector working to support medicines optimisation?

Methods:

A team of researchers at Newcastle University conducted a qualitative study performing in-depth semi-structured interviews with 23 key medicines optimisation and IT stakeholders between January - March 2022. Interviews lasted approximately 1-hour. Interviews and fieldnotes were transcribed and analysed using the Framework approach. Themes were discussed and refined and applied systematically to the dataset. Member checking was also performed.

Results:

This work revealed themes and subthemes pertaining to three key areas: (1) Transfer of Care Issues; (2) Challenges of Digital Tools and (3) Future hopes and opportunities. We identified significant complexity in terms of the number of different medicines management systems used throughout the region and important challenges around having access to incomplete patient records. We also highlighted barriers relating to: using multiple systems and the impact on user-workflow, interoperability, digital gaps, IT systems management and change management. Finally, participants described their hopes and opportunities for the provision of medicines optimisation services in the future: there was a clear need for a patient centred consolidated integrated health record for use by all health and care professionals across different sectors, bridging those working in primary, secondary and social care.

Conclusions:

The effectiveness and utility of shared records depends on the data within, and therefore healthcare and digital leaders must support and strongly encourage adoption of established and approved digital information standards. Further specific priorities around understanding the vision for pharmacy services and supporting this with appropriate funding arrangements and strategic planning of the workforce were also described. In addition, the following were all identified as key enablers to harness the benefits of digital tools to support medicines optimisation in the future: development of minimal system requirements, enhanced IT system management to reduce unnecessary repetition, and importantly, meaningful, and continued collaboration with clinical and IT stakeholders to optimise systems and share good practice across care sectors.