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The Real World

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The past few weeks of my pre-registration training have been interesting on a personal note.  Generally, it would seem that even some of the simpler tasks are over complicated in some way. This can be frustrating. For example, a simple drug history can be complicated. Barriers and distractions can easily arise, meaning time is lost. As somewhat of an idealist, I believe that centralisation of patient records and the increase use of information communication technology will have a massive impact in the way pharmacy and medicines are managed throughout the healthcare system.


Of course the true potential of ICT in healthcare is yet to be met due to a number of reasons. Cost and confidentiality are two I can think of. Who wants their personal records kept on a national database?  How is consent defined on a national level? How much would it cost to fund a scheme of this proportion? Although the debate is far more complicated than these questions, it’s nice to be dreamer. Hopefully information and communication gaps between primary and secondary care will one day be minimal through the use of computers and the internet.


I was greatly interested when I found out the Audit Commissions 2001 review of medicines management in hospital stated this ‘Computerised systems containing rules to prevent incorrect or inappropriate prescribing have also reduced the incidence of errors and increased the appropriateness of medicine treatment’. This statement seems so obvious and highlights the benefit of e-prescribing. I am unaware of the rollout of e-prescribing throughout different trusts but the benefits cannot be ignored.


Ideally, a database type system that is linked to the BNF could potentially reduce the number of medicines errors (I type this like it’s a really easy thing to achieve; my computing A-level baffled me enough). More information could also be seen including the indication of medicine, the ranges of doses etc. Once a pharmacist has clinically checked this e-prescription, it could then be dispensed via a robot and podded up to the ward automatically. Now clearly, I am entering fairy land. But imagine the possibilities. The pharmacist wouldn’t have to leave the ward at all and could have more involvement in patient care. 

The technology exists but the implementation is far from real at this time. Although the ideas I think about are triggered by minor events and the ideas are often that of grandeur, I would rather be a dreamer of real potential than a dweller on the negatives.  I think my colleagues/friends will find that hard to believe.

Audit Commission (2001). A Spoonful of Sugar - Medicines Managment in NHS Hospitals. London: Audit Commission. p25.

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