Medications data using a CareConnect #FHIR API

Bristol, North Somerset & South Gloucestershire (BNSSG) Connecting Care

Expected Benefits

This new controlled drugs information, together with the medications information from the GP system (and soon hopefully the acute hospitals and community pharmacies), will begin to create an overview of drugs prescribed for an individual. Sharing this information with authorised staff as soon as it is entered into Theseus will help to increase patient safety and reduce costs.

Expected Benefits

This new controlled drugs information, together with the medications information from the GP system (and soon hopefully the acute hospitals and community pharmacies), will begin to create an overview of drugs prescribed for an individual. Sharing this information with authorised staff as soon as it is entered into Theseus will help to increase patient safety and reduce costs.

“I have had several patients, recently released from prison, who I have been able to clearly see are receiving scripts from rapid prescribing, but in many ways the more useful information is the group where I have been able to verify that they are not receiving a service from rapid prescribing. These are usually the recently released offenders who have been released, gone on a bender for several weeks, not turned up at probation or rapid prescribing, and have not received any OST. These are the most at risk group. I have then been able to prescribe safe in the knowledge that this will not be duplicate prescribing.”
Lead GP – The Homeless Health Service, Bristol

Expected Benefits

This new controlled drugs information, together with the medications information from the GP system (and soon hopefully the acute hospitals and community pharmacies), will begin to create an overview of drugs prescribed for an individual. Sharing this information with authorised staff as soon as it is entered into Theseus will help to increase patient safety and reduce costs.

  • ‘Close the gap’ in controlled drug prescribing knowledge and help prevent potential duplicate prescribing events and reduce the likelihood of death or serious incidents to reduce patient harm.
  • Benefit both organisations (reduction in duplicate prescribing) and individuals (reduction in duplicate prescribing).
  • Improved messaging technology means that it should be easier to link with the two other controlled drugs databases in North Somerset and South Gloucestershire to access their information in the future.
  • A report by PwC, commissioned by the Department of Health “A review of the potential benefits from the better use of information and technology in Health & Social Care”, states – the cost of Adverse Drug Reaction (ADR) related admissions is £1.9Bn per annum. Indeed an assumed 6.5% of hospital admissions are thought to be a result of adverse reactions with an average stay of eight days.
  • It is reasonable to assume, based on the high levels of utilisation of medication and allergy information in the system, that Connecting Care will support a significant reduction in adverse event related admissions.
Introduction BackgroundSolution
GPs now have a reliable, quick efficient way of knowing whether the patient in front of them is receiving opiate substitutes from drug workers outside practice-based care.

Clinicians often struggle to retrieve a patient’s medications history to prepare a list of collated medications as the data is, typically, stored across a number of systems.

In Bristol, the Connecting Care Programme has developed a solution which involves adopting FHIR to address the needs of medication reconciliation.

The initial aim is to avoid substance misuse (specifically opioid substitution therapy drugs) within Bristol but there are far wider future aims.

The project’s primary aim was cutting drug related deaths and near misses across Bristol due to opioid substitution therapy drugs over-prescription. Without joined up systems, it is impossible for prescribers to get a real-time accurate overview. Those most at risk from the ‘gap in care’ around controlled drugs are often the homeless and the most vulnerable. This project aimed at providing greater patient safety to those at risk.

This was a very rapid project; from design to go-live took just seven weeks. Across this locality, all the GPs and the 3 Community Providers used the EMIS system. In essence the project was, therefore, about linking two separate systems via FHIR. The project used agile methodology coupled with feasibility studies. Clinicians came together to produce a series of user profiles.

The Care Connect interface linked Orion Health’s integrated digital care record and the Cyber Media drug and alcohol system, Theseus, which is used by Bristol City Council. The Connecting Care platform is able to connect 27 organisations across 85 GP Practices, NHS Hospitals, Community, Mental Health and Out of Hour Services, Social Services, Paramedics, Charities and Hospices.