Thank you Rachael. I’d love you to head to the first post in this thread, which is a Wiki, and make any edits that you see fit. It is a bit of a learning curve to do so, but in time this has the potential to revolutionise how we share information within the health informatics sector.
They aren’t quite there yet from what I understand, but are in the testing and pre-implementation phase.
The same is true for Better Meds in the Midlands region.
Any progress updates on hospital outpatient eprescribing across the country?
Any new (or imminent) Apps not mentioned previously or sites that have implemented one of the previously mentioned eg Indici.
Hi Simon I wrote this story recently about the 3 Wellington DHBs and Bay of Plenty DHB going live with indici for outpatients https://www.hinz.org.nz/news/news.asp?id=603391&terms="outpatient+and+indici"
@karenshaw @annie.joe at 3DHB are contacts re that.
If you hear of any others let me know!
The 3 Wellington DHBs have around 20 ePrescribing systems.
Wow, imagine trying to corral those
4 posts were split to a new topic: Sharing software within Te Whatu Ora effectively
Hi All
Integrating with NZePS for outpatient prescribing.
Like some other regions we created the ability to email prescriptions to community pharmacy directly from our Electronic Clinical Record (CWS*), based on the covid-19 waiver in April 2020.
For the last 4 months (since April 2022) Waikato have been integrated with NZePS for outpatient prescribing, and no longer dependent on covid-19 waiver.
About to start integrating electronic prescribing within our Discharge Summary also within CWS.
If you are considering developing your own integration:
Regards
Paul Docherty - Senior Analyst, CWS Dev Team, Information Services, Waikato Region
m021852019 paul.docherty@waikatodhb.health.nz
Thanks Paul - you remind me that it is time this wiki had some attention.
Any edits / contributions to the wiki up the top is most welcome!
Outpatient prescribing from public hospitals
What work is currently happening on this nationally to enable electronic prescribing in this setting?
In my current role at Te Whatu Ora Southern (formerlly Southern DHB covering), I have fielded enquiries from clinicians and service managers wondering when they will be able to write electronic prescriptions for their outpatient clinics. Currently our default option for this is paper prescriptions.
I’m aware there are moves to get a national solution here.
I’m wondering if anyone on this forum can give a brief overview of how that is going and if there are any even provisional timeframes for this? It would be useful to know as in the meantime we are making do with interim solutions and how much effort we put into these solutions will depend on how long we are expecting the interim solutions to need to last for.
Hi Damon,
Great - and important - question!
We are fielding similar enquires in Canterbury, and the clock is ticking loudly on the waiver expiration date of Oct 2024, meaning we can no longer send our electronically generated but not NZePS compliant scripts via the ERMS referral system to pharmacies (the system that was put in place during Covid).
Regarding a national solution for outpatients - this sits under the Digital Medicines Portfolio as a workstream called ‘Outpatient and community-based specialist services’.
Some of the solutions being reviewed/considered are Indici, Medimap, ?MedChart (I haven’t seen MedChart for OP explicitly stated, although for outpatient prescribing from public hospitals (rather than ‘community prescribing’) it seems sensible to review/consider the application used for inpatient prescribing where functionality for outpatient prescribing exists).
The Digital Medicines Portfolio workstreams sit under the Medicines Management Digital Services Oversight Group.
Regarding your question around interim timeframes - this isn’t yet known as the solution/s haven’t yet been decided. @vidhya.makam Is there any more information you can provide Damon, and others on this forum, re: this workstream?
Thanks,
Olivia
Indeed – Emergency Department in Canterbury is, effectively, paper-only for prescribing via the Orion medicines tool.
Inpatient has MedChart and its use has been considered in the ED, but we’re already struggling with IT-related inefficiencies and we’re up to nearly 400 patients per day, and I guarantee we (our patients) cannot suffer any further impediments to staff productivity …
@oliviaclendon thanks for including me in this conversation.
@damon - one of the key requirements for a outpatient prescribing system is to be able to send NZePS compliant prescriptions. From a national medicines portfolio perspective we have been reviewing the existing solutions to identify the 1or 2 tactical solutions in this space as per the directive from Leigh. I will connect with you directly to give you an update on the systems. Anyone interested can contact me on vidhya.makam@tewhatuora.govt.nz
From a GP perspective, I’d love to see interoperability in these systems. Right now, it is creating more work when I see a patient who is living in a type of residential care where they use one of these systems: I need to prescribe in my PMS, then update MediMap or 1Chart with separate login, which is quite painful…
I understand the issue with electronic prescribing of CDs has been approved in application such as Medi-Map which seems to be the most widely used in Aged Care and Addiction services. It might be worth looking into…
@bev Hi Bev, lopping you into this eHealth Forum chat on outpatient prescribing options as I believe you are currently working on a discussion paper for this nationally. There may be contacts in this group who can assist with current and proposed future state discussions.
I do understand the frustration as our services went through an implementation of 1Chart across the country and of course heard this from numerous GPs. We have fed this issue back to 1Chart. Unfortunately for all of us when PMS systems and electronic charting systems are being created interoperability does not seem to be prioritised. I am aware that 1Chart is working on this issue and hopefully there will be some improvement to come. I do wonder if there needs to be some boxes (such as interoperability) that need to be ticked by Te Whatu Ora before a health related piece of software is allowed to be marketed/sold within the country.
Home and community prescribing and administration
At Nurse Maude, our district nurses currently use paper medication administration charts, and our prescribers (community palliative care) use paper prescriptions. We are really interested in finding an electronic solution that improves safety and efficiency, and in particular one that is integrated with the rest of the health system. As @Tania mentions the interoperability with GPs, as well as other systems is paramount.
Great to have this discussion and will be following closely for any updates.
Bev Nicolls reacted to your message:
YES!!! And, it must be detailed what that interoperability looks like from the user perspective . . .in the US funding was tied to such a tick box between EHRs, but the loop-hole was the ‘interoperability’ was not defined, so the EHRs stated they’d met that criteria, and so claimed the millions of $ in funding, but their ‘interoperability’ was actually just enabling a medical file to be ‘downloaded’ . . . into a PDF!!! . . . and then read thru another EHR, as a PDF, . . . so, actually not usable data.
My understanding is the API-based ecosytem of Hira is trying to move in the direction of usable interoperability . . . but, unclear how quickly that can be implemented. All good things take time, of course, but maybe it’s worth having some form of policy at the funder-level, that any public funding going towards a new IT product must include the commitment to all data to be pushed and pulled from their software . . it would be nice if interoperability was a top consideration during contract negotiations, as it does have safety implications.
Hi @emily.gill 
Totally agree with you regarding the need for actually detailing what interoperability looks like for the user/system - we MUST get better at defining our requirements before we ask the vendors to implement the ‘solutions’.
I agree that a good start (you have to start somewhere) is a commitment from vendors - and I’d argue it needs to be current and future/proposed - towards interoperability by way of sharing data AS coded data (and not text/pdfs/application specific codes).
For the whole system to work, the whole system has to work!!