Introduction

The Digital Medicines initiative aims to positively transform the way that

Patients manage their medicines, promote new models of care as well as improve the medicines supply chain and the provision of medicines data. At a high-level, this all involves the adoption of digital prescriptions to replace inefficient and cumbersome paper versions, utilising appropriate technologies to fully engage in the end-to-end Patient pathway, alongside supporting the adoption of technology to deliver a fully digitised medicines supply chain. 

The Digital Medicines Specification utilises

the Generic FHIR Receiver and supports the following requirements as part of its MVP.

Requirements

Compliance, Assurance and Testing

Summary of Recommendations

The understanding that clinical risk and assurance responsibilities are formally acknowledged by system

Suppliers and based on the knowledge that appropriate functional assurance will be performed by the

Solutions Assurance team which is crucial to mitigating many of the clinical risks identified,

 the following clinical assurance approach is recommended:

1. Clinical Safety

All system

Suppliers will be required to submit the required clinical safety documentation and sign off by their Clinical Safety Officer as per the

Authority Clinical Safety Group (CSG) requirements

2.

 Test in Test

A Digital Medicines clinician will, in the test environment via Webex, witness test the following scenarios to ensure the systems are behaving as expected from a clinical perspective. The scenarios covered will be:

1. The end to end process including the recording of a Patient consultation for a flu vaccination, where a vaccination has been administered and the subsequent transfer of that information to a GP Practice where it is acted upon.

1. The end to end process including the recording of a NUMSAS consultation for a Patient where a supply is made, the subsequent transfer of that information to a GP Practice where it is acted upon.

1. Test in Live

Using test Patients, a Digital Medicines clinician will, in the live environment via Webex or in person, witness test the following scenarios to ensure the systems are behaving as expected from a clinical perspective. The scenarios covered will be:

1. The end to end process including the recording of a Patient consultation for a flu vaccination, where a vaccination has been administered and the subsequent transfer of that information to a GP Practice where it is acted upon.

1. The end to end process including the recording of a NUMSAS consultation for a Patient where a supply is made, the subsequent transfer of that information to a GP Practice where it is acted upon.

The focus of the witness testing will be on the user workflow ensuring the positive and negative messages are prominent to the user and to provide a “sense check” of the PDF transformation of the message received by the GP system.

Documentation

The latest version of Digital Medicines specifications can be accessed here: https://digital.nhs.uk/developer/api-catalogue/digital-medicine-fhir  (Reference links: https://developer.nhs.uk/apis/). 

The first stage of the standard is now published

 and details the information that should be recorded for vaccinations administered and emergency medicines supplied by community pharmacists.

The MVP states that

Suppliers are expected to process the unstructured messages upon entry to the framework in order to compliantly implement any use cases. However, there will be a future requirement for

Suppliers to further enhance their

Solutions to ensure the messages are processed in a structured format.

Dependencies

Creating a compliant implementation requires implementing the following dependent interface standards:

• Generic FHIR Receiver

Roadmap