EPharmacy Workshop 17 March 2008-Minutes

Venue

• Brussels, 17 March 2008 from 10-17hr

Participants

• Belgium : P. Houben (APB)
• France : J. Surugue (EAHP), F. Gener (Phast), T. Mitouard (Mc.Kesson), N. Canu (Phast), S. Letellier (EAHP/Phast), J. Nies (Medasys), E. Serrot (Vidal), A. Estelrich (DMP)
• Greece : L. Tzimis (EAHP)
• Netherlands : A. Blom (KNMP), M. Sprenger(NICTIZ), R. Moss (EAHP)
• Italy : S. Cozzolino (EAHP)
• Spain : Juan Suarez (Indra)
• IHE Eur : G. Claeys (Agfa Healthcare), C. Parisot (GE Healthcare)

All Documents

• Ftp site : ftp://ftp.ihe.net/International/Europe/Development/Pharmacy/Meetings/Meeting17March2008/
• Zip archive: here

Update on e-pharmacy activities

• ASHP (American Society of Health-System Pharmacists)
  • Debriefing of HIMSS meeting : summary
  • ASHP is open to co-operate; initially to review the proposed use cases; in a later phase as member/sponsor of the global IHE Pharmacy domain. Primary focus is hospital pharmacy
• HITSP overview :
  • HITSP is an initiative of the USA government to develop healthcare IT standards for different clinical domain, incuding e-pharmacy. A draft specification for medication management is available here which focuses on workflow among hospital/consumers/pharmacists and health insurances.
  • Action : Identify the sections in the proposal that can be re-used for our community pharmacy Use Cases.

Use Cases :

• Overview : mindmap
• Scope : the initial Use Cases will be developed for drug related workflow. In a later phase, additional Use Cases will be developped for handling sterialized medical supplies (e.g. catheders) and chemicals/regents (e.g. acetone)
• Use Case priorities are re-confirmed :
  • Prio 1: Electronic transfer of prescriptions (community & hospital pharmacy), medication management (community pharmacy)
  • Prio 2: Medication management for hospital pharmacy (intake&discharge medication)
• Hospital Pharmacy Use Cases :
  • Use Case Team : F. Gener/N. Canu (principal editors), T. Mitouard, S. Letellier , R. Moss , L. Tzimis, S. Cozzolino , J. Surugue, I. Gibaud, V. Mary
  • High level proposal : here .
  • Proposal is a generalization/simplification of hospital pharmacy use cases for France and defines 4 main use cases
  • Feedback :
    • Add actor “Prescription validator” who analysis and validates the prescription
    • Add new transaction between “Prescriber and Prescription validator” to propose alternative prescription when the initial prescription is rejected
    • Add actor (“Medication Publisher/Subscribers”) and transactions to publish medication information to multiple Medication Subscribers (e.g. to include mediation history in the patient’s EHR)
  • Updated document will be presented at the next ftf meeting
• Community Pharmacy use cases :
  • Use Case Team : Juan Suarez (principal editor), P. Houben, E. Serrot, A. Estelrich, A. Blom, M. Sprenger,
  • High level proposal : Use Cases Spain and Use Cases France (briefly discussed by absense of the author)
  • Focus on medication management and prescription management
  • Feedback
    • Use cases must support a document centric architecture (e-prescriptions are handled as persistent documents) which is complementary to message centric architecture of hospital pharmacy. This is in line with the other IHE domains where extra-hospital workflow is document centric (e.g. XDS) and intra-hospital workflow is message centric (e.g. IHE scheduled workflow)
    • Use Cases should support a push model (direct transmission of e-prescription between GP and Pharmacist) and a push-pull model (e-prescription is stored in an intermediate repository).
    • Add XDS actors (document repository/registry)
    • Add actor (“Medication Publisher/Subscribers”) and transactions to publish dispensed medication information to multiple Medication Subscribers (e.g. to include dispensed mediation in the patient’s EHR)
    • Medication history should only contain dispensed medication, not information about contra-conditions, alergies
    • Align the actor definition with hospital pharmacy actors
    • Add actor “Prescription validator” who analysis and validates the prescription
    • Add new transaction between “Prescriber and Prescription validator” to propose alternative prescription when the initial prescription is rejected
    • Add actor (“Medication Publisher/Subscribers”) and transactions to publish medication information to multiple Medication Medication Subscribers (e.g. an EHR document producer)
  • Updated document will be presented at the next ftf meeting

Next steps

• Involve other countries : Germany and UK (J. Surugue)
• And in the future, the drug agencies (e.g. EMEA)

Timing

Comment: Should submit application to form IHE Pharmacy Domain to the IHE Board in Mid-2008

• June 2008 : Finalise main Use Case; submit to global IHE Development committee
• Mid 2008 – Mid 2009 : profile development (as global IHE Pharmacy committee)
• 2010 : Test IHE Pharmacy implementations at connectathons