software. This software manages repeat script processing between GP and
pharmacy and works with the underlying clinical system. This
interworking is provided either via an API, in co-operation with the
clinical system supplier, or using Reuters "Encounter" screen scraper
technology which allows an interworking without the clinical system
suppliers co-operation. (PRS claim this will work with all major
systems, EMIS say not with theirs. It work with System 5, VAMP Medical
and at least two others to my certain knowledge). Script Manager
hardware and software is provided free to GPs.

Script manager connects to PRS's database using Racal Healthnet and the
infrastructure already in place  to support GH-HA links. The systems
currently only handles repeat scripts but PRS say it will be extended to
cover acute scripts.

Where the patient has requested that their scripts are transmitted to a
"Health Plus" pharmacy the repeat is produced and transmitted ahead of
the expected due date (subject  to certain compliance and GP
authorisation rules) without the need for the patient to request the
repeat. Data transmitted is only that which would normally be on the
script plus some non-contentious additional items to control the repeat
prescribing process. Data is encrypted and identifiers are transmitted
separately link by a code which would be meaningless  to  anyone
intercepting the data.

Patients wishing to use the system will be expected to "register" with a
particular "Health Plus" Pharmacy" to which the script will be forwarded
by the PRS central system using ISDN. The electronic script will be with
the pharmacy some days before the patient is expected and the systems
supports a stock check and if needed an electronic order can be
triggered to ensure the item is available when required. PRS recognises
that for the medium term the existing paper form will also need to be at
the pharmacy before the script can be dispensed and pharmacies will have
to make arrangements to collect scripts from GPs

It is hoped the removal of the need for patient request could have
significant impact on the workload of practice staff handling repeat
prescribing and the existence of the PRS service might spur regulatory
change which could allow further improvements in the efficiency of
repeat script processing.

The script will carry a bar code on the right hand tear off portion of
the form and this will be used in conjunction with a bar coded patient
held card and to link the paper and electronic script, finally by
scanning the pack bar code a complete audit trail and check that
prescription and items dispensed match is provided. Details of items
dispensed are passed back to the GP providing valuable compliance
monitoring.

Any purchase of OTC medicines in any "Health Plus" Pharmacy are also
recorded in the PRS database. This allows interaction and other safety
checks against all items prescribed in any "Health Plus" pharmacy.
Subject to patient consent details of any  OTC drugs purchased are
passed back to the GP.

The system can optionally prompt the pharmacist to provided compliance
counselling tailored to the needs of the specific patient with the
potential for GP input into the counselling message. It is intended that
the pharmacist will receive an additional fee for this service. For high
value branded medicines this fee would be paid by the manufacturer. It
is envisaged that for some other products Health Authorities might pay
this fee where it could be demonstrated that improved compliance would
reduce costs elsewhere in the system.

All the data flowing through the system is stored on PRSs central
database which sits on a dedicated DEC alpha array in Racals ultra high
security data centre in Runcorn.

PRS have stated categorically that they don't intend to use the data for
purposes other than the provision of the services described. The flow of
data in the system and release of data to GP's and pharmacists is
controlled on the basis of explicit consent of the parties involved
allowing various levels of data sharing.


Ewan Davis
[log in to unmask] - Bromsgrove, UK

Managing Director AAH Meditel Ltd - Supplier of EMR Systems.
[log in to unmask] Voice +44 (0)1527 579414 Fax +44 (0)1527
837287


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