With pharmacy teams under more time and financial pressures than ever, it is critical that they get the best out of their PMR systems.
But with legacy systems sometimes decades old, is there still scope for pharmacists to get more out of their current PMRs – or should they be considering an upgrade?
As well as sitting on PSNC’s Community Pharmacy IT Group as vice chair, David Broome is the director at Stancliffe Pharmacy in Leeds. He has used Positive Solutions’ Analyst PMR for the past 15 years and says the secret to getting the most out of it – and, indeed, any PMR system – is not to get complacent about how you use it.
“One of my biggest concerns is that pharmacies pay all this money for a PMR system and then only use about 20 per cent of it, as we are so wedded to doing things the way we’ve always done them,” says Mr Broome.
“I’m not a systems geek, but over the years of using ours, I regularly look at what we do with it and work out what we can do better. It’s finding multiple little wins that make one big win, so it’s about looking for them, using them and embedding them into your processes.”
Paul Mayberry – managing director of Mayberry Pharmacy Group in Wales – made his own big win when he created the Pharmacy-X cloud-based PMR system to address a niggling feeling that community pharmacy technology is what he calls “really backward”.
“I think it’s because of the complacency of the incumbent PMR suppliers,” says Mr Mayberry. “There is no driving force for them to move forward – no matter how little you innovate, your customers won’t go anywhere else.”
The flip side of this, he says, is that systems users don’t progress with how they use their PMRs either. “Because innovation has been stifled, we tend to be luddites when there potentially are other ways of doing things,” he says.
He also points to other obstacles, even for business owners who are willing invest in new systems.
“Changing a PMR system isn’t just changing a bit of software,” Mr Maybury adds. “It governs the whole workflow in your pharmacy, so you need to retrain your staff to understand it, which is why if there’s no great benefit from changing, you don’t change.”
Being ready to make changes, but not seeing a system on the market that he felt met his needs was what inspired Mr Mayberry to create Pharmacy-X, from which he has rapidly seen the benefits.
“For example,” he says, “Pharmacy-X can download the prescription, the pharmacist clinically checks it and then doesn’t have to see it until the next patient review, unless there is a change or addition to their medication, giving us an 80-90 per cent reduction in the time our pharmacists spend checking repeat prescriptions.”
As a result, Mr Mayberry says the Pharmacy-X customer base is “growing really well, with a customer pipeline in Wales alone that is stretching into the autumn, and a queue of people in England also wanting to have it installed”.
Another disrupter in the PMR market, Tariq Muhammad – CEO of Invatech Health and creator of the Titan PMR system and Titan.X pharmacy AI – has seen his customer base continue to expand. Mr Muhammad says “record numbers” of users signed up to Titan in February alone, with numbers increasing each month. As a result, Invatech has doubled its staff to 50 in the last year to meet demand.
“One of my biggest concerns is that pharmacies pay all this money for a PMR system and then only use about 20 per cent of it, as we are so wedded to doing things the way we’ve always done them”
As well as becoming the first PMR system to be fully EPS-accredited by the NHS for dispensing doctors in March, the company has also developed a number of new apps for its Titan Marketplace in a bid to further streamline its user experience. These include BatchFlow, which enables pharmacy staff to group batches of prescriptions together and pick into one tote after they have been received and clinically checked, and RepeatFlow, which automates the ordering cycle for patients and surgeries when repeats are due.
The long-standing market players – perhaps in response to the new challengers in the PMR space – are also taking steps to innovate.
With more than 5,300 pharmacies across the UK using EMIS ProScript Connect PMR software, Sima Jassal – pharmacist and clinical director for the company – says EMIS is continuing to invest to “meet industry challenges head on in the short and the long term”.
With open APIs enabling greater integration with third parties, the company is driving new capabilities within ProScript Connect through its cloud-based platform EMIS-X, where all new EMIS software will be based.
“Looking to the cloud, we envisage a future where end-to-end script management from download to handout is radically more efficient, leveraging more intelligence and automation, requiring fewer clicks and keystrokes,” says Ms Jassal. “As service provision becomes a key focus, we’re also addressing the need for centralised appointment booking and calendar management, which includes integration with the NHS’s Booking and Referral Standard (BaRS).”
With 2023 marking the 30th anniversary of Positive Solutions, Steve Russell – the company’s chief commercial officer – says this year is set to be its busiest yet, with a range of new products and initiatives.
The HxConsult services platform – which already features CPCS referrals and private vaccinations – adds NMS, DMS, Covid and NHS flu, along with Consultation Wizard, which allows contractors to build a suite of bespoke services. The HxCare eMAR solution has entered the pilot stage, with the aim of providing what Mr Russell calls “a cost-free solution” for contractors managing care home businesses. The MyHealthHub patient app has also hit the market in England (Scotland and Wales are to follow), offering repeats, appointment booking and local-to-local Royal Mail rates as well as being fully integrated into a PMR system.
Coming this summer, HxIntel will provide contractors with ‘live’ data dashboarding and reporting, and the company’s HxDispense cloud-based and device agnostic PMR platform will enter pilot testing in late summer/early autumn.
Risks and benefits
Unsurprisingly, all of these players can talk up the risks and benefits of their own systems, and of PMRs in general – although they don’t always agree on what to look out for when choosing a system.
“It’s important to consider the long-term strategy when it comes to selecting a PMR system,” says Ms Jassal. “The supplier needs to have a clear forward direction, focused on system development and integration with partner applications to ensure that you’re investing in the future.
“To be capable of fulfilling the evolving needs of community pharmacies as the healthcare landscape changes, the PMR supplier needs to have the right level of investment in place as well as the breadth of reach across the healthcare ecosystem to drive system evolution.”
“The supplier needs to have a clear forward direction, focused on system development and integration with partner applications to ensure that you're investing in the future”
He adds: “Traditional PMRs leave you to process everything manually and most likely carry on doing things the way the previous owners did. Titan has only been around for less than four years, yet we have disrupted the market and introduced concepts and innovations that have eluded the sector for decades.”
On the subject of risks, Mr Russell says: “I am going to discount the new entrants to the market as I think, particularly at this juncture, choosing an unproven system with no track record or heritage would be the pharmacy equivalent of playing Russian roulette right now.”
But whichever vendor contractors may be looking at, Mr Russell says there are five critical points to consider when choosing a PMR:
- Firstly, ask what their product can do to save you time and money, freeing up your clinicians to generate additional revenue, such as delivering services
- Secondly, make sure that they have put as much effort into their support infrastructure as they have into their software – when you need it most, you don’t want to be chatting to an online bot or waiting days for a response – and check that they are accredited by a third party
- Thirdly, make sure you fit your PMR to your business needs, not the other way around
- Fourthly, think about the vendor’s road map and how aligned it is with your strategy and the direction of travel of the funding framework and the NHS
- Finally, make sure the PMR provider sees you as more than just another contractor. Choose someone you know you can work with and trust to look after you, your team and your patients.
There is, of course, a step to consider before going for something new. “We are paying a not insubstantial amount for our PMRs, but are we doing everything we can to get the best out of them?” asks Mr Broome.
“Yes, there’s a lot of improvements that all the systems could have, but they are all on a journey too, and I do believe that a lot of pharmacists are still using the functionality of their PMR in the same way they did 20 or 30 years ago. The benefits are there, but there’s no point pushing for more if you’re not already making full use of what you’ve got.”