emas walkthrough registration, registration updates and consultation
TRANSCRIPT
eMAS Walkthrough
Registration, registration updates and consultation
Core Infrastructure Components
Prior to ePharmacy the systems and communications infrastructure consisted of the computer system in the pharmacy and the payment processing and associated systems at practitioner services with communication via paper prescription forms and reports.
Practitioner Services
CHI
Pharmacy
Pharmacy system
PrinterPayment processing
systems
Practitioner Services
CHI
Pharmacy
Pharmacy system
PrinterPayment processing
systems
N3 network
Community pharmacies need to have a connection to the N3 network. This is achieved as an independent connection or as a ‘corporate’ connection.
Practitioner Services
CHI
Pharmacy
Pharmacy system
Printer
ePharmacyMessage
Store
Payment processingsystems
N3 network
The ePharmacy message store provides a secure, resilient, single point of contact for all messaging for MAS and all future ePharmacy applications.
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system
Printer
ePharmacyMessage
Store
Payment processingsystems
N3 network
Remunerating pharmacies on a capitation basis requires a central patient registration system (PRS) to support this. The system contains the rules for patient registration and integrates with the payment systems and the CHI system to provide CHI numbers to pharmacies.
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system
Printer
ePharmacyMessage
Store
Payment processingsystems
N3 network
Updated MASpharmacy system
MAS
The Minor Ailment Service requires new ways of working in the pharmacy. Pharmacy systems have developed support for the new service as well as developing the messaging support required to participate in ePharmacy.
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system
Printer
ePharmacyMessage
Store
Payment processingsystems
N3 network
Electronicmessages
Updated MASpharmacy system
MAS
Electronic messages are used in addition to paper CP2 forms. The messages allow for ‘real time’ responses to registration requests and the delivery of CHI numbers. The electronic data is used in place of the paper forms in payment processing to vastly improve data capture.
Registration
Registration Process• Individual’s data
– Name– Address– Date of birth– Exemption status
• Enter data on PMR system• Central Patient Registration System (CPRS) via
N3• Registration confirmed with CHI number
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
ePharmacyMessage
Store
Person presents and wants to register for MAS.
Information is captured and added to the pharmacy system (or an existing record is updated).
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
ePharmacyMessage
Store
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
ePharmacyMessage
Store
CP2 form for registration is printed and person signs to confirm their exemption status. The person can leave at this point.
If the CHI is not known at the time of registration the DoB is placed in CHI field and 4 digits are added at the end.‘0008’ shows a patient born in the 19th Century‘0009’ shows a patient born in the 20th Century‘0000’ shows a patient born in the 21st Century
Pharmacy details are automatically added.Patient details are automatically added.
Further automatic additions include:DatePS Contractor CodeRPSGB Reg Number
CP2 type and sex of patient is automatically printed.
A unique barcode is created on the CP2 registration form. The barcode number is also part of the registration message sent from the pharmacy PMR. A registration barcode number begins with the letters RE.
Registrationrequest
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
ePharmacyMessage
Store
… and an electronic message is sent.
Registrationmessage
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
ePharmacyMessage
Store
Registrationrequest
The message is directed via the ePharmacy store to the Patient Registration System (PRS).
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
ePharmacyMessage
Store
Registrationmessage
Registrationrequest
The PRS applies the registration rules and locates the person on CHI then records the person as registered at the pharmacy.
RegistrationResponse (with CHI)
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
ePharmacyMessage
Store
Registrationmessage
Registrationrequest
Registrationdetails updated
PRS then replies with the registration status and CHI number and the information is automatically updated on the pharmacy system. Registration is complete.
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
ePharmacyMessage
Store
RegistrationResponse (with CHI)
Registrationmessage
Registrationrequest
ImageStore
Later… CP2 registration forms are submitted by the normal route to Practitioner Services where they are imaged and stored. (The registration is already complete).
‘deferred’ registration
Recap: Patient presents to register. The patient’s details are added or updated on the pharmacy system. A CP2 for registration is printed and a registration message is sent. The PRS responds confirming registration and returning CHI number. The patient record is automatically updated.
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
Registrationrequest
RegistrationmessageePharmacy
MessageStore
Registrationdetails updated
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
Registrationrequest
RegistrationmessageePharmacy
MessageStore
What if a registration response is not received?There are a number of reasons why this might happen…
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
Registrationrequest
RegistrationmessageePharmacy
MessageStore
The patient may not be uniquely identified on CHI. (Perhaps details match a number of entries, e.g. twins or perhaps the patient has only recently moved to Scotland).
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
Registrationrequest
RegistrationmessageePharmacy
MessageStore
The patient registration service may be unavailable or undergoing routine maintenance.
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
Registrationrequest
RegistrationmessageePharmacy
MessageStore
The ePharmacy message store may be undergoing routine maintenance or the connectivity from the pharmacy may be temporarily unavailable.
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
Registrationrequest
RegistrationmessageePharmacy
MessageStore
‘Pending’ registration – OK to proceed
Important. If any of these events occur there is no interruption to MAS provision. The patient is recorded as ‘pending’ registration and a MAS consultation CAN be performed. The registration request will be completed.
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
Registrationrequest
RegistrationmessageePharmacy
MessageStore
There is resilience built in at each stage.A process on the pharmacy system will attempt the resend the message taking care of even prolonged communication interruptions.
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
Registrationrequest
RegistrationmessageePharmacy
MessageStore
There is resilience built in at each stage.If PRS cannot be contacted in ‘real time’ then the message will be delivered in ‘batch’ for processing overnight.
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
Registrationrequest
RegistrationmessageePharmacy
MessageStore
€PRS Operations
There is resilience built in at each stage.If a unique match cannot be found PRS operations team can manually find the correct patient.
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
ePharmacyMessage
Store
The registration response is delivered via a registration update once completed.
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
ePharmacyMessage
Store
Registrationupdates
The patient registration delivers registration updates to the ePharmacy message store.(These include completed deferred registrations and changes notified from CHI).
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
ePharmacyMessage
Store
Registrationupdates
Registrationupdaterequest
Registrationupdateresponse
Registrationdetails updated
The pharmacy request registration updates (suggest daily) and these are delivered to the pharmacy system where the patient records are updated.
Registration Updates
Practitioner Services
PatientRegistration
System CHI
Pharmacy
Pharmacy system Printer
ePharmacyMessage
Store
Registrationupdates
Registrationupdaterequest
Registrationdetails updated
OvernightProcess
•Deferred registration results•Withdrawal
•Death•Care home•Registration at another pharmacy
•Lapsing pharmacy•Roll-on
Consultation
Care Provision• Person presents at their pharmacy
• Pharmacist checks their eligibility
• Pharmacist consults with person
• Pharmacist offers– Treatment and advice– Advice only– Referral – Associated healthy lifestyle advice
Pharmacy
Pharmacy system Printer
Practitioner Services
PaymentProcessing
ImageStore
ePharmacyMessage
Store
Person presents for a MAS consultation.
Pharmacy
Pharmacy system Printer
Practitioner Services
PaymentProcessing
ImageStore
ePharmacyMessage
Store
The person’s registration status is checked on the pharmacy system and eligibility re-confirmed.
Pharmacy
Pharmacy system Printer
Practitioner Services
PaymentProcessing
ImageStore
ePharmacyMessage
Store
•Treatment•Advice•Referral
The person and pharmacist consult deciding on an outcome.
Pharmacy
Pharmacy system Printer
Practitioner Services
PaymentProcessing
ImageStore
ePharmacyMessage
Store
•Treatment•Advice•Referral
Labels
Information is recorded on the pharmacy system to support the dispensing and labelling process (if treatment is required).
Pharmacy
Pharmacy system Printer
Practitioner Services
PaymentProcessing
ImageStore
ePharmacyMessage
Store
Labels
A CP2 form is printed (the information is gathered as a by product of the labelling process). The pharmacist signs the CP2 form and the person signs to confirm their exemption status. The person can leave.
1. If the CHI is not returned following a registration the consultation can still go ahead.
2. The CP2 consultation form will be printed as normal but the CHI will be missing. The patient signs the CP2 and can leave the pharmacy.
3. Before you can send the CP2 consultation form to Practitioner Services, you must wait until you receive the CHI in a message and hand write it onto the form.
Endorsing information is added to the CP2.
A maximum of 2 items may be dispensed during 1 eMAS consultation.
If you have given advice or referred a patient to their GP, this will be indicated on the CP2 consultation form.
A unique bar code is created on the CP2 consultation form. The barcode number is also part of the consultation message sent from the pharmacy PMR. A consultation barcode number begins with the letters CE.
Pharmacy
Pharmacy system Printer
Practitioner Services
PaymentProcessing
ImageStore
ePharmacyMessage
Store
ConsultationClaim
ClaimAcknowledgement
Labels
… and an electronic claim message is sent and receipt is confirmed by the ePharmacy store.(Note: the claim has not yet been verified and passed for payment). Consultation is complete.
Pharmacy
Pharmacy system Printer
Practitioner Services
PaymentProcessing
ImageStore
ePharmacyMessage
Store
Labels
ConsultationClaim
ClaimAcknowledgement
Later… The CP2 forms are submitted by the normal route to Practitioner Services.
The barcode on the form is read and the electronic message is retrieved. The electronic message information is used in place of the information that would otherwise be scanned from the CP2 form.Note: handwritten information is not used!
Pharmacy
Pharmacy system Printer
Practitioner Services
PaymentProcessing
ImageStore
ePharmacyMessage
Store
Read barcode& get message
Labels
ConsultationClaim
ClaimAcknowledgement
Pharmacy
Pharmacy system Printer
Practitioner Services
PaymentProcessing
ImageStore
ePharmacyMessage
Store
Read barcode& get message
Labels
ConsultationClaim
ClaimAcknowledgement
The CP2 forms are imaged and stored.
Questions?