It was December 2022 and at Solidsoft Reply we were all getting ready for Christmas: eating mince pies, decorating trees and jingling bells. A selected few in Solidsoft Reply, including myself, who were involved in developing eCDR-Pro, were also getting ready to finally see the results of all the long hours we had put in. This marked the culmination of a journey that had begun during the bleak days of the Covid-19 lockdown.
I would be lying if I were to say that it had all been plain sailing – such things only occur in poorly-written fiction. Instead, it had very much been a process filled with discovery and learning, which had encompassed the full spectrum of emotions from sheer frustration to absolute elation and everything in between. It had also been a process that fostered growth, understanding and the development of a sense of trust and mutual respect between Solidsoft Reply and the Calderdale and Huddersfield NHS Foundation Trust (CHFT). Ultimately, this journey had culminated in the successful implementation of eCDR-Pro, a co-designed software solution for the management of Controlled Drugs (CDs) in acute clinical settings.
Solidsoft Reply specialises in software solutions for the healthcare and pharmaceutical industries, among others. Amidst the backdrop of Covid-19, as individuals and organisations were adapting to new ways of living and working, Solidsoft Reply and CHFT came together to find a solution for tracking CDs movements across hospital pharmacies, wards and theatres in a fully auditable way. The old pen and paper method was prone to human error and placed additional administrative burden on the already overstretched nurses. Each day, they had to reconcile the CD amounts and try to work out where the mismatched doses had gone.
From left to right: Sarah Helen Perera Bammanage, Federica Massagrande and Harsha Issack in the pharmacy of the Huddersfield Infirmary (March 2023)
Right from the start, the initiative began as a collaborative co-design exercise. Solidsoft Reply brought expertise in software development and CHFT contributed their deep understanding of hospital operations, so we relied on each other for the project’s success. Over site visits, observations on the ground, conference calls and many reviews, a design started to come together. It required many iterations, involved some dead ends and some false paths, but eventually the first version of the eCDR-Pro design was ready for the development team to transform into a concrete output. The very early iterations established the importance of keeping the UI design and the workflows as clean and straightforward as possible – Solidsoft Reply aimed to make the nurses’ and pharmacists’ lives simpler, saving them time and eliminating guesswork.
Solidsoft Reply learnt the intricacies of hospital operations, how CDs move within the clinical environment and the unique nuances across various wards. For instance, theatres have slightly but, crucially different, requirements from standard wards and need their own distinct workflow variations. CHFT learnt that there is more to writing software than merely saying “the solution needs to do this”, and that Solidsoft Reply would go back and ask lots of questions about all aspects of “this” and the processes around it. Together Solidsoft Reply and CHFT watched the eCDR-Pro come into being. CHFT tried and tested each new added component and provided us feedback, indicating what worked and what didn’t work. We collaboratively explored the edge cases and found out how to deal with them – for example, it is commonplace knowledge in the CHFT hospitals that CDs do not move across wards, except that they actually do if a patient with a drip is transferred from a ward to another, and that needs to be taken into account by the solution to accommodate such scenarios.
After several months of development, reviews and testing, the result was a piece of software that precisely aligned with CHFT’s needs. They did not need to adapt their processes to the software – the software was their process and therefore seamlessly integrated with their existing workflows. Along the way both Solidsoft Reply and CHFT increased their knowledge of each other’s industries, and a strong partnership was created. Perhaps the most important realisation was that what we were doing wasn’t just delivering a new software solution to a customer, it was creating a tool that made it easier for pharmacists, anaesthetists and nurses to do their jobs, freeing up their time and providing them with the prescriptions they needed as and when they needed them for efficient and effective patient care. I remember sitting in a meeting room in the Huddersfield Infirmary, listening to the pharmacist explaining how the night before, while at home on call, she received an urgent phone request for a CD from a ward. She logged onto eCDR-Pro, found which wards had stock of the required CD and relayed the information to the caller. This took five minutes. Before eCDR-Pro went live, in similar situations she would have needed to drive to the hospital and go through the stock books to find the CD, while both the nurse and the patient waited impatiently.
Our eCDR-Pro solution has been live at CHFT for over a year, with new wards coming online on a regular basis and continuous enhancements being made to improve the workflows. As of today, 48 wards and theatres are live across two hospitals, and the solution’s capabilities have expanded to include inter-pharmacy processes beyond the original code base. eCDR-Pro will continue to grow, it will adapt to CHFT’s evolving requirements, facilitating improvements to their way of working that would not have been easily achieved before. Any new upcoming enhancement to eCDR-Pro will make it a little bit easier for pharmacists, nurses and anaesthetists to perform their roles, positively impacting patient care, while providing full auditing of all actions. With many exciting improvements already in the pipeline, watch this space to find out where the solution will be going next.
“But what about the overworked nurses?” you’ll ask. Thanks to eCDR-Pro, they no longer need to while away the hours reconciling CDs and doses across scribbled paper registers. They also no longer need to rush from the ward to the pharmacy with a prescription, only to later call the pharmacy about its availability, and then dash back to the pharmacy to pick it up, before returning to the ward to administer or store it. With eCDR-Pro, apart from physically transporting the CDs from one location to the other, these processes are now automated and accessible through a user-friendly interface, ensuring full auditability. As a result, we have saved tens of thousands of hours of nurses’ time annually by eliminating the need for them to go between the wards and pharmacies.
So, there you have it! The collaborative partnership and co-design approach resulted in a solution that, let me repeat it, is the CHFT’s process. This is a far cry from picking off-the-shelf products and then retrofitting your own processes to accommodate them. Unlike off-the-shelf products, eCDR-Pro contains no wastage – all its features and functions are needed and used by CHFT. Conversely, with off-the-shelf software you are always buying a packaged product that contains, on top of the functionality you are looking for, many features that you do not need or care for, yet that you have to pay for.
Here’s to many more NHS Trusts choosing to go the co-design way. Solidsoft Reply stands ready to offer our expertise and support to drive them towards success, should they decide to take the plunge and embark on this transformative journey.
Solidsoft Reply is a leading technology company creating award-winning solutions utilising the Microsoft Azure cloud platform. As a globally acclaimed Microsoft AI Cloud Solutions Partner, we specialise in GS1 traceability systems worldwide, crucially ensuring the authenticity, legality, and safety of our customers’ products and services. Serving non-profits, NGOs, healthcare, and the pharmaceutical industries, we deliver technology for positive social impact. Your products, safe in our hands.