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Our IT systems need to focus on the patient

A coroner recently criticised a pharmacy IT system, suggesting that it could have contributed to the death of a child. Could this be the time to pause and ask whether our pharmacy systems are fit for purpose for the future, asks Liam Stapleton

Prior to 1990, pharmacy systems were only used to create labels and order stock but then, in the early 90s, a contractual obligation was introduced that required pharmacies to keep medication records. 

This was originally done on paper but dispensing systems were developed to keep these records and many wholesalers provided computers linked to an ordering capability. 

These caught on quickly as there were operational benefits from recreating labels for repeat dispensed items. There were also clinical benefits as changes to medication and potential prescribing errors could be identified during the dispensing process.

These systems evolved with new functionality and modules but they were never integrated. Pharmacy teams still need to access different systems to receive referrals, record service delivery and claim payments. 

The data that has been collected is functional, collected for the purposes that pharmacy teams have used it for – dispensing and ordering medicines. Data is generally not collected about OTC medicine sales, services provided or advice given as this has not been required. Yet if the core function of any IT system is to facilitate effective workstreams and produce quality outcomes, what should such a pharmacy system look like?

Core functionality

Looking to the future, pharmacies will be providing clinical services to patients as their core value proposition to the NHS and local communities. They will have an ongoing relationship with patients where services are linked and build on each other, or are delivered over a period of time. The nature of the relationship with patients will be ongoing rather than transactional. 

Pharmacy systems should therefore be focused on patients and be clinically enabling. They will hold patient information that enables services to be delivered, drawn from a range of sources – services such as a common ailments scheme, CPCS and flu vaccinations, as well as dispensing-related services such as the NMS and DMS (and, of course, dispensing itself). 

“Pharmacy systems should be focused on the patient and be clinically enabling”

This internal integration of information will be enhanced by external integration, drawing information from NHS platforms such as the National Care Records Service, and GP and hospital systems, and will also allow information to be posted back to them, allowing efficient collaboration with the wider healthcare team.

External integration will also allow referrals to be received in real time and instant claims for payment to allow for efficient process management. Appointment systems will support pharmacy teams to deliver services efficiently.


Pharmacy systems of the future must be proactive. They must provide reports that identify patients for whom a specific service may be appropriate and flag it in their record. Report development will be intuitive and support clinical audit and service improvement.

Dispensing will be a key module that links to the main clinical system. It will highlight patients who need to be offered a service in real time during the dispensing process. The system will record clinical checks to allow repeat dispensing to be undertaken efficiently. This will allow pharmacists to focus on the ‘business end’ of dispensing where the value is – optimising medicines usage and improving patient outcomes. 

Advice will be recorded and messages sent directly to the prescriber to request medication changes. Safeguards will prevent dispensing if any changes have been made or after a set period of time. Effective ordering and stock management will be part of this module.

This is not an evolution of current pharmacy systems but a revolution, a reinvention based on a changed core purpose. What we don’t want is to be anchored to the past by systems that don’t deliver, clinically, what pharmacists need.

• Liam Stapleton is director of Metaphor Development Limited and an associate clinical lecturer at the University of Lincoln.

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