Combating falsified medicines in Africa through digital artefacts

Falsified medicines are again in the news, this time in a piece for the BBC News’ websites business section. In his article, Matthew Wall looks at the problem of combating falsified, counterfeit and substandard anti-malarial medicines in Africa through the use of alternative technologies for tracking the identity of the medicines’ original pack – the original pack being the box of 14 or 28 tablets received for the patient

Hub and spoke dispensing: safety and sociotechnical pliability

Over the course of the last year, the Department of Health has looked at the use of hub and spoke dispensing systems for community pharmacy in England, a technology which some view as an inevitable extension of electronic prescription transmission in primary care. In a hub and spoke system, medicines required for a primary care prescription are put together at a remotely located warehouse and then transported to a spoke site, such as a community pharmacy, where they can be collected by the patient. The economies of scale that such a model offers support the use of robotic dispensing

Accelerating access to new drugs in Japan

Writing in Nature Reviews Drug Discovery, Yasuhiro Fujiwara outlines developments in Japan to reduce the time required for new therapeutic drugs to gain marketing authorisation

Hub and spoke dispensing: privacy and sociotechnical rigidity

In a previous post, we noted how a hub and spoke model for community pharmacy had been promoted on the basis of a limited safety case. The hub and spoke model that was described was one in which items would be assembled at a hub site that would serve a number of dispensing sites, such as community pharmacies. Although the hub and spoke model has been used by a number of companies, changes to the law were required to allow community pharmacies to buy access to hub services from a company other than their own

Nature reviews research into cybercrime

For all the talk of hard mechanical and technical defences, all human-machine systems are reliant on their soft procedural defences to maintain safety and security. This insight has some traction amongst the safety science community and has now also taken hold in the security community as a recent review by M. Mitchell Waldrop for Nature illustrates

Brexit and the falsified medicines directive

In order to help patients avoid being exposed to falsified medicines, the European Commission developed a series of measures to support patients in identifying licenced suppliers of pharmaceutical medicines, and suppliers to identify whether an end-user pack of medicines was genuine. The measures outlined in the Falsified Medicines Directive (2011/62/EU) have been applied across the European Union (EU), with the exception of requirements to verify the identity of the end-user pack, which was not due to be completed until 2019

National electronic health records implementation: a tale with a happy ending?

Apparently similar top-down strategies led to different outcomes in Singapore and England, write Ela Klecun, Ya Zhou, Atreyi Kankanhalli, and Ralph Hibber

Meeting user needs in national healthcare systems: lessons from early adopter community pharmacists using the electronic prescriptions service

BACKGROUND: The Electronic Prescription Service release Two (EPS2) is a new national healthcare information and communication technology in England that aims to deliver effective prescription writing, dispensing and reimbursement service to benefit patients. The aim of the study was to explore initial user experiences of Community Pharmacists (CPs) using EPS2. METHODS: We conducted nonparticipant observations and interviews in eight EPS2 early adopter community pharmacies classified as ‘first-of-type’ in midlands and northern regions in England. We interviewed eight pharmacists and two dispensers in addition to 56 hours recorded nonparticipant observations as field notes. Line-by-line coding and thematic analysis was conducted on the interview transcripts and field notes. RESULTS: CPs faced two types of challenge. The first was to do with missing electronic prescriptions. This was sometimes very disrupting to work practice, but pharmacists considered it a temporary issue resolvable with minor modifications to the system and user familiarity. The second was to do with long term design-specific issues. Pharmacists could only overcome these by using the system in ways not intended by the developers. Some felt that these issues would not exist had ‘real’ users been involved in the initial development. The issues were: 1) printing out electronic prescriptions (tokens) to dispense from for safe dispensing practices and to free up monitors for other uses, 2) logging all dispensing activities with one user’s Smartcard for convenience and use all human resources in the pharmacy, and, 3) problematic interface causing issues with endorsing prescriptions and claiming reimbursements. CONCLUSIONS: We question if these unintended uses and barriers would have occurred had a more rigorous user-centric principles been applied at the earlier stages of design and implementation of EPS. We conclude that, since modification can occur at the evaluation stage, there is still scope for some of these barriers to be corrected to address the needs, and enhance the experiences, of CPs using the service, and make recommendations on how current challenges could be resolved

The dynamics of institutional pressures and stakeholder behavior in national electronic health record implementations: a tale of two countries

Through electronic health record implementation, national healthcare systems are aiming for care integration and enhancement. However, the path to large-scale electronic health record implementation is seldom smooth, involving multiple stakeholders with diverse interests and influences. This study proposes a framework that draws on both stakeholder and institutional theories to understand the complex dynamics of stakeholder interactions and institutional pressures over time during electronic health record systems implementation. This framework is utilized to analyze the national electronic health record programs of Singapore and England, which provide contrasting perspectives on how two top-down system implementations took place with different outcomes. Our results suggest that in the Singapore case, the presence of boundary spanners, supporting implementation agency that included IT staff from healthcare organizations, and greater engagement with medical professionals were associated with more positive dynamics of stakeholder interactions (e.g. limited pushback from professionals or the press) during electronic health record implementation than in England. Differences in the healthcare structures and systems, electronic health record project organization, and the combined influences of institutional pressures shed light on the varying implementation paths and outcomes in the two cases. This study adds to the health information technology literature through a comparative examination of the organizational and social processes during complex national healthcare integration projects. It also contributes to the institutional and stakeholder literatures in several ways, in particular by depicting the processes and outcomes of the dynamics of isomorphic pressures played out under different institutional conditions. Finally, our proposed framework provides a useful conceptual tool for analyzing such complex IT implementations across multiple stakeholders

Characterisation of a filter-based external quantum efficiency measurement system

Accurate assessment of external quantum efficiency provides information useful for understanding where losses in energy conversion efficiency occur in solar cells. These systems are typically designed to measure small areas only, which makes it impossible to measure the quantum efficiency of monolithically integrated modules and thus any effects due to interconnection cannot be assessed. A system for measuring spectral response has been designed and recently commissioned at CREST with a view to making measurements on larger areas. The external quantum efficiency of solar cells is calculated based around a series of narrow-band interference filters and homogenising optical elements that are able to provide a large-area, homogeneous, monochromatic illumination. In this paper the initial characterisation of the system will be presented. It is the intention to further improve the functionality of the system over the coming year and the planned enhancements will be discussed in light of their effects on measurement accuracy, in particular for devices such as dye cells and multi-junction cells which have more complicated electro-optical characteristics than basic silicon wafer cells