e-prescribing risks patients

Monday September 10th 2018

e-prescribing risks patients

Written by Marie Sharp, Local Democracy Reporter

An electronic prescribing system could have put people at risk after its system crashed, health chiefs have warned.

The ILLY prescribing system used by Midlothian Health and Social Care Partnership within its substance misuse service has been identified by them as a key risk.

But, they said, returning to manual prescribing would also bring risks because it would then rely on people completing prescriptions accurately.

In a report to Midlothian Integration Joint Board’s audit and risk committee, the prescription service was one of four key “high level” risks identified to the board.

It said of the prescribing system: “There is a risk that patients could be harmed because of recurring issues with the electronic prescribing system and the termination of the current licence leading to potential errors and delays due to manual completion of a significant number of prescriptions.”

The partnership’s risk register identified the issue as a 16 on the risk scale, placing it at high risk.

It said the partnership had raised the risk with the management of other health and social care partnerships and REAS (Royal Edinburgh Hospitals and Associated Services) and solutions had been sought.

It added: “A business case has been submitted to Lothian eHealth in April 2017, identifying a replacement prescribing system which does not require yearly license fees and addresses the stated issues around security and functionality.”

The highest risk on the partnership’s register with a score of 20 was delayed discharge with patients at risk of being unable to leave hospital when ready because of the “insufficient community supports” available.

The report said delaying a patient’s release from hospital risked “leading to deterioration in their health, beds being blocked and elective operations potentially being cancelled”.

The partnership implemented a range of measures to try and tackle the issue including increasing support to care at home services.

Meeting demands for community care with reduced budgets was a third key risk identified with concerns that an increasing elderly population and increase in adults with disabilities and complex needs would put added pressure on finances.

Meanwhile, commissioned care providers were identified as the main threat to the board’s capacity to find voluntary and private sector firms to support its needs.

The risk from commissioned care providers were stated to be “delivering poor quality care that places service users at risk of harm; unable to meet the increasing demands for provision particularly in relation to care at home; and ceasing trading due to financial difficulties creating risks around service provision for large groups of very vulnerable people.”

Dr Tracey Gillies, Medical Director, NHS Lothian, said: “ILLY Prescribing software is a bespoke system that allows our substance misuse clinical teams, across Edinburgh and the Lothians, to record prescriptions electronically.

“NHS Lothian is working with all four health and social care partnerships to establish the future provision of a prescribing system that can be used across substance misuse sites.

“Earlier this year, the software experienced technical issues which meant the system was unavailable for short periods of time. Patient safety was not compromised and no harm was caused. Additional controls were introduced and no subsequent incidents have taken place.”

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