Derby starts drive for safer and more informed electronic prescribing for hospital patients

Hospital staff to gain enhanced prescribing guidance, linked to patient information, as DXC Technology’s Lorenzo ePMA is deployed as part of a wider electronic patient record programme

DXC Technology (NYSE: DXC) is collaborating with Royal Derby Hospital, part of the University Hospitals of Derby and Burton NHS Foundation Trust, on an initiative that will better alert doctors to genuine prescribing dangers, electronically link patient information and best practice to prescribing decisions, and improve patient safety whilst reducing pressure on staff.

E-prescribing and medicines administration, or ePMA, is part of a much larger hospital digitisation programme in Derby underpinned by DXC’s Lorenzo electronic patient record (EPR) system. As a next-generation EPR, Lorenzo is both interoperable and expandable, and it is designed as the heart of a best-of-breed healthcare architecture.

Deployment of the ePMA component of Lorenzo has already started at the Derbyshire Children’s Hospital and will extend to all inpatient areas in Derby, replacing an outdated electronic prescribing system.

Debbie Loke, deputy chief information officer at the trust, said: “Enabling safer, faster and more informed prescribing for busy doctors and nurses and the patients they look after is a core ambition in our transition to Lorenzo ePMA. Unlike most hospitals embarking on digitisation programmes with the Lorenzo EPR, electronic prescribing is not new for us. However, staff will benefit from a much more intuitive, mature and connected system, configured around their workflow. This will better guide their decisions and alert them to real risks.”

The new ePMA system will sit alongside several specialist prescribing systems used in areas such as oncology and critical care. It will integrate with crucial patient information held in the trust’s EPR, facilitating suggestions and alerts based on an individual patient’s circumstances.

Matt Elliott, the pharmacist responsible for overseeing ePMA systems at the trust, said: “This is about helping to guide prescribers – giving them suggestions based on the best practice, the latest drug prices, clinical guidance, prescribing policy and the context of a patient’s history.

“Our staff are already familiar with the typical benefits of electronic prescribing – such as having access to information in different locations, legibility or being alerted to patient allergies.

“We now want to go much further with Lorenzo, pre-populating the system with common doses and using relevant linguistics so prescriptions can be issued quickly and easily. Linking to the EPR will mean prescribers have drug orders, lab tests, drug administration and patient information all in one place and they can benefit from proactive suggestions for patients with specific conditions and comorbidities.”

Dr Sam Thacker, associate clinical informatics officer at University Hospitals of Derby and Burton NHS Foundation Trust, said the new system could check for conflicts for patients with chronic kidney disease, heart disease and other illnesses, whilst also helping to avoid alert fatigue.

“Every extra alert that is extraneous comes with a cost,” he said. “We can stratify alerts in Lorenzo and manage them so the most dangerous and more uncommon things are more likely to interrupt users’ work than the more common and benign. We haven’t had the ability to do that before. Now something minor will show as text, whereas if a prescriber presses ‘OK’ on something potentially fatal – they have to enter a reason. That is a big improvement.”

Dr Thacker added the new system would also help with drug administration, planning rounds and boosting compliance with drug administration policy.

“Additional safeguards will bring us down the road of better safety – with fewer errors. We can help to ensure harm is minimised and that any causes are recognised,” he said. “This is something Lorenzo will help us to realise.”

Colin Henderson, director of healthcare and life sciences for the UK, Ireland, Israel, the Middle East and Africa (UKIIMEA), at DXC Technology said: “Digital technology has the power to transform care and improve safety in the increasingly pressured environments faced by healthcare professionals in NHS hospitals. The work at Derby is a great example of taking established technology and configuring it to real clinical workflows. There is clearly strong commitment from hospital leadership, digital specialists and healthcare professionals in Derby to ensure technology provides the meaningful insights clinicians need to deliver the best outcomes for patients.”


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