"MedInfoSys has transformed the way we work, and our ability to respond quickly, efficiently and effectively. I look forward to seeing where we can take it next" - Tim Donaldson, RDTC, NHS (See NB at foot of page>

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The centre aims to promote safe, effective, and economical use of medicines in the NHS in the Northern and Yorkshire region, to promote the highest quality of care for people exposed to the toxic effects of drugs or chemicals, and to disseminate and develop knowledge in these areas through teaching and research.

A multi-disciplinary team – consisting of pharmacists, medical information scientists, poisons information nurses, clinical pharmacologists and a teratologist – provides information services about medicines, poisons and teratology to doctors and other healthcare professionals, 24 hours a day, 7 days a week.

The team also analyses prescribing data for Primary Care Trusts, and functions as an adverse drug reaction MHRA regional monitoring centre for the Committee on Safety of Medicines.

The Business Context
Until the implementation of a web-based enquiry management system from New Information Paradigms (NIP) in 2003, all enquiries received by the RDTC were recorded on paper forms. Secretaries then entered selected enquiry data into Access databases, but this situation was far from ideal. As Tim Donaldson, Head of Information Services at RDTC, says:

“A lot of time was spent on relatively low-level data entry, which was laborious and time-consuming, especially as a lot of data was effectively entered twice. Beyond that, we had problems retrieving previous enquiries, accessing and recording enquiries outside regular office hours, and accessing relevant information when writing responses. So, not only was time being wasted, but getting critical information to enquirers was proving increasingly difficult“

Following the rapid growth in the number of enquiries received after the North England poisons centres were merged in 1999, it was clear that resolving these issues was a main business priority (see right).

Achieving consistency and efficiency across the 2 sites was a priority, and the RDTC looked to find a way of improving both the enquiry logging and response processes. This meant finding a system that could:

• Provide “real time” data entry within a multi-user networked environment
• Handle broad enquiry management processes (such as workflow, letter production, etc)
• Cater for the very specialised demands of poisons and teratology enquiries, escalating into other systems where appropriate
• Support clinical, risk management and corporate objectives
• Produce system reports, so that workload and the meeting of response targets could be monitored
• Release staff time to undertake higher-level activities

Getting Started
RDTC obtained time-limited funding in April 2002, meaning that deadlines were critical. Working with the internal IT department and an external IT consultancy, the project team sent out an invitation to tender in June, before issuing a detailed specification in October.

Tim Donaldson: “Having decided that we didn’t have the resources to build a system ourselves, we decided to see what was available. Ease of use and trouble-free operation were priorities. We wanted a well-established system, but also one that could be quickly configured to suit our specialised data collection and escalation requirements: that rather ruled-out the generic CRM packages”.

The solution had to comply with NHS IT procurement and quality control standards, and it was decided that it should be web-based for ease of access. The successful vendor would also have to demonstrate responsiveness when it came to specific poisons and teratology functionality.

A standardised scoring system was used to assess vendors in November, and NIP was selected – a selection that was confirmed during December, as requirements were further explored. Significantly, the contract was signed without NIP and RDTC staff having met each other, demonstrating the capabilities of virtual working.

Tim Donaldson: “NIP’s web-based MedInfoSys system is highly flexible and could quickly incorporate our specific needs. At the same time, core system features were impressive, such as the full searchability, reporting, reference materials management, audit trailing and letter production. Finally, NIP has over 10 years’ experience in this specialised area, which gave us a high degree of confidence about working with them”.

Implementation and Deployment
Development work on the project began in January 2003 with an imminent go-live date of April 1st. The RDTC used the PRINCE 2 project management methodology, the lightweight nature of which enabled them to balance twin project goals of quality control and flexibility.

On the quality front, work on the system was highly documented and controlled, beginning with a tight specification. Flexibility was equally important, though, as this specification changed as the project developed. This combination of tight deadlines and changing requirements was challenging, but didn’t prevent the delivery of the system on time.

Tim Donaldson: “We would have liked more time for the implementation phase of the project. However, resources were stretched, and we also found that as the system took shape, we needed to refine some elements of the specification. Despite this, NIP were able to respond to changes, actively engaging the users in deciding how the system should evolve to meet the deadline.”

Post-Deployment
After the initial push to go live and resolve outstanding questions and issues, the system now works well. MedInfoSys has proven popular with RDTC staff, especially as it means that they can now work without paper. Workflow and efficiency have improved immensely, as enquiries – up to 4000 a month – can easily be captured in “real time”, with all past enquiries easily searchable. All reference materials are also searchable and it is easy to use them to generate enquiry responses.

Of equal importance has been the way that supporting the system has been handled - NIP is based in Crowthorne; RDTC is based in Newcastle. It wasn't feasible or cost-effective to make site visits for each support item - and, before that, during development. Accordingly, the RDTC system was developed and is supported remotely, with all issues reported and investigated online, and system diagnostics performed on the server from within NIP.

This reflects NIP’s belief that if a system is designed to function on the web, allowing virtual collaboration, it should be possible to support that system to similar standards - something that RDTC has come to rely on.

Tim Donaldson: “Initially, we wondered how remote support would work, but in practice it's been a really positive experience. Far from being anonymous or unresponsive, it's got us faster results. On a personal level, it has been energising working with NIP and overall, MedInfoSys has transformed the way RDTC works, and our ability to respond quickly, efficiently and effectively. I look forward to seeing where we can take it next.”

© May 2004

NB: Tim Donaldson is no longer an employee of the Regional Drug and Therapeutics Centre, and these are his personal comments.