Project Overview
An NHS Integrated Care Board (ICB) overseeing medicines optimisation across a network of 48 GP practices wante...
Technology Stack
Compliance & Standards
The Challenge
An NHS Integrated Care Board (ICB) overseeing medicines optimisation across a network of 48 GP practices wanted to build a digital medicines optimisation platform. GPs were spending an estimated 2.5 hours per week on prescription management queries — managing repeat prescriptions, medication reviews, high-risk drug monitoring, and Medicines Use Reviews (MURs). DTAC all 5 domains, UK GDPR Article 9, NHS Login, and GP Connect FHIR R4 were mandatory. Budget: £85,000.
Our Approach
GP Connect FHIR R4 Integration
- GP Connect Appointments (book appointment from platform), GP Connect Record Access FHIR R4 (read patient medication records with GP authorisation), and GP Connect Update Record (write structured medication review outcomes back to patient record).
- NHS Smartcard authentication for clinical staff accessing GP Connect.
- High-
Risk Drug Monitoring Automation
NICE and BNF high-risk drug monitoring schedules built into the platform: Methotrexate (monthly FBC, LFT), Warfarin (INR monitoring frequency per patient's stability), Lithium (quarterly renal, thyroid, lithium level).
Automated alerts
patient overdue monitoring test triggers GP alert.
Escalation
monitoring not completed within tolerance window triggers pharmacist clinical review.
Synchronisation analysis
- patients with multiple repeat items with different review dates create polypharmacy management complexity.
- Platform identifies synchronisation opportunities — aligning all repeat items to a single monthly review date reduces administration.
- Estimated 40% reduction in prescription management queries for synchronised patients.
Highest hazard
incorrect medication record (mitigated by GP Connect read-only for display — no write except structured outcome).
Clinical Safety Officer
pharmacist CSO, not IT professional (the clinical nature of the risk requires clinical professional as CSO).
Hazard Log
medication alert suppression (alert incorrectly cleared) — mitigated by permanent audit trail of alert acknowledgements.
The Results
DTAC approved all 5 domains.
Platform live at 16 weeks, £78,000 — under budget.
GP prescription query time: 2.5 hours/week → 40 minutes/week average.
High-risk drug monitoring compliance: 76% → 97% of patients within monitoring schedule.
Repeat prescription synchronisation: 34% of patients synchronised in first 6 months.
Patient safety event: zero adverse drug events related to monitoring in first 12 months (3 in previous 12 months).
“Zero adverse drug events related to monitoring in the first 12 months. That is the only metric that ultimately matters — patient safety. The high-risk drug monitoring compliance going from 76% to 97% is what delivered that outcome." — ICB Chief Pharmacist (name withheld)”
Project Details
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