Medication Management Implementation Manual
	Programme	NPFIT	DOCUMENT NUMBER
	Sub-Prog/Project	Comms & Messaging	NPFIT-FNT-TO-DPM-0602
	Prog. Director	Paul Jones
	Sub-Prog/Proj Mgr	Ken Lunn
	Author	C&M Development Team	Version No.	2.3.1
	NPO/PSO Contact	Richard Kavanagh	Status	Issued

 

 

Contents

 

 

Change History

In Version	Author	Date	Amendment Details
1.0	Core Technical Team	10/05/2004	First Issue
1.1	Core Technical Team	17/06/2004	TBD
1.2	Core Technical Team	20/07/2004	Updated to comply with the clinical statement pattern.
1.2	Core Technical Team	17/09/2004	Messages aligned with CSMP 1.4
1.3	Core Technical Team	24/09/2004	Fixed incorrect links within section 6
1.4	Core Technical Team	29/10/2004	Model changes as required to resolve issues raised on MIM 3.1.06. New wrappers applied. Examples updated. See section 10.
1.5	Core Technical Team	06/12/2004	Model changes as required to resolve issues raised on MIM 3.1.07. Examples updated. Previous section 8 - Interaction Index removed. Examples in external documents section by scenario. Non Core-ETP examples not provided..
2.0	Core Technical Team	13/06/2005	Model changes as required to resolve issues raised on MIM 3.1.08. Interactions changed to use application acknowledgments where appropriate. See section 10 for more details.
2.1	C&M Development Team	05/09/2005	Update to models and tabular views to address issues raised on MIM 4.0 ETP 2.0. Removed Personal Administration and Protocol Supply form the MIM. See section 9 for more details
2.2	C&M Development Team	16/12/2005	Removed all references to PA and PS artefacts from this IM; made minor technical corrections to tabular views and example messages - no artefact version changes made; updated Cancel Request to include OriginalPrescriptionRef  for use by PSIS and added new PSIS Cancellation Notification.  See section 9 for details.
2.3	C&M Development Team	28/04/2006	Miscellaneous minor updates and technical corrections to IM, tabular views and code sets.  See section 9 for details.
2.3.1	C&M Development Team	12/10/2006	Corrected hyperlink in section 6.11 Subsequent Cancel Response - PORX_IN050102UK32 to reference the correct schema.

 

 

1    Overview

The message definitions accessible from within this document have been defined to support a number of business processes, namely:

 

• Prescribe, Non Nominated Pharmacy, Dispense + Reimbursement, Claim Accept
• Prescribe, Nominated Prescription, Dispense, Dispense + Reimbursement, Claim Reject, Claim Resubmit
• Prescribe, (Repeat Dispense, Non-Urgent), Nominated Pharmacy, Dispense (with not required), Reimbursement Claim, Claim Accept
• Prescribe, Cancel Item, Nominated Pharmacy, Dispense Notification, Reimbursement Claim Information, Claim Accept
• Prescribe, Cancel Prescription, Non Nominated Pharmacy
• Prescribe, Non Nominated Pharmacy, Dispense Return
• Prescribe, Nominated Prescription, Dispense Return, ETP Response (Return Rejection)
• Prescribe, Prescription Rejection
• Prescribe (non-urgent), Non-Nominated Pharmacy, Release Rejection
• Prescribe, Nominated Prescription, Dispense Notification, Dispense Notification Rejection
• GP Dispensing
• No Claims

 

 

2    Storyboards

2.1    Prescriptions Creation Prescribe, Non Nominated Pharmacy, Dispense & Reimbursement, Claim accept

The following clinical scenario demonstrates the process for an acute prescription:

 

Justine Thyme goes to see her GP, in Tops Surgery in Toytown, because she has a nasty cough and is producing ill smelling green phlegm. Dr Indiana Jones, on clinical examination, decides that Justine has a chest infection.

 

He asks her whether she is allergic to anything, specifically penicillin. When she answers ‘No’, he completes an electronic prescription form for ‘Amoxycillin 250mg capsules, 3 times daily, for 5 days’.

 

Dr Jones then asks Justine if she wants the prescription to go to her previously nominated pharmacy. She answers ‘No’ and he annotates the prescription to denote this. He then completes the prescription process by digitally signing the prescription and printing the ‘token’ which Justine will need to present to whichever pharmacist she decides to visit.

 

Once in town Justine enters the Potions Pharmacy on the High Street and presents her ‘token’. The dispenser scans her token into the local system which then requests the ETP System for the particular prescription order for Justine.  The prescription is shown as “to be dispensed” and with no nominated pharmacy, so the system authorises the release of that prescription to Potions Pharmacy.  [The status of that prescription on the ETP System is now “with dispenser”].

 

In the pharmacy, the prescription is dispensed in the usual way.  The pharmacy staff check Justine’s exemption status, which is “non-exempt”, so they collect the appropriate prescription charge from her, and enter this into their pharmacy system.

 

Peter Potion checks the prescription, then, as he hands her the medication, checks with Justine that she is both clear about when to take the medication and that she has no unanswered questions.  Justine then leaves the Pharmacy.

 

As the full prescription has been dispensed [status - fully dispensed], Peter decides to send a combined “Dispense Notification and Reimbursement Claim” message to the Spine, to update Justine’s clinical record, and to claim reimbursement for this dispense event.

On receipt of this message, the ETP System system updates Justine’s  clinical record with the dispensing information, changes the prescription status to “fully dispensed” (i.e. completed) and forwards information on the prescription, the dispense notification and the reimbursement claim to the reimbursement authority (PPA in P1R2).

 

The reimbursement authority receives this information, processes it, and sends a system level transport layer acknowledgement to the ETP System.  No formal acceptance message is sent to the dispenser; it is assumed that, if no rejection message is received, the claim is accepted and will be paid in the normal way.

 

 

2.2    Prescribe, Nominated Prescription, Dispense, Dispense + Reimbursement, Claim Reject, Claim Resubmit

 

The following clinical scenario demonstrates the process for repeat prescription:

 

Two and a half months ago, Nell Gwyn has decided that she wanted to use the Oral Contraceptive. She saw her doctor, Charles Stuart, who started her on Loygynon tablets, with prescription for an initial three months’ supply.  He explained to Nell that he will allow this prescription to be repeated 3 times before she would need to be reviewed, and that to get the new prescription for the next 3 months’ supply all she has to do is contact the surgery to arrange the new prescription to be issued.

 

He annotates Nell’s notes with this information and sets a review date for Nell in the clinic in 12 months time.

 

Now, Nell needs a further supply of her medication, so she phones the surgery and lets the receptionist, Polly Parker, know that she needs a repeat prescription.  She has previously “nominated” Potion’s Pharmacy as her nominated pharmacy, and asks that the prescription be marked to be sent to her nominated pharmacy.  Polly looks at Nell’s electronic notes and sees the annotation previously left by Dr Stuart. She lets Nell know that the prescription will be ready later that day.

 

Polly lets Dr Stuart know that the prescription needs to be re-issued (mechanism dependant on practice rules). Dr Stuart calls up the prescription, re-authorises it creating another prescription and then digitally signs it.  A ‘token’ is then printed for Nell to collect.

At the usual time, Potion’s Pharmacy sends a request to the ETP System for all the prescriptions with status “to be dispensed” and with their nominated pharmacy as Potion’s Pharmacy.  Today, Nell’s repeat prescription for Logynon is one of these.  The information for this, and all the other prescriptions, is sent to Potion’s Pharmacy using Nominated Prescription Repeat Response messages; the status for these prescriptions is then set to “with dispenser”.

 

The pharmacy dispenses the prescriptions in the normal way. Nell comes in to the surgery later that day and collects the new token. She then goes to Potion’s Pharmacy and presents the token to Pharmacist Peter, who looks on his local system, finds the prescription details and checks the contents of the package against the prescription token.  Unfortunately, the pharmacy only has two months’ supply of medication in stock, so Peter explains this to Nell, who accepts Peter’s apologies and agrees to call back in the near future for the balance.

 

After Nell has left the pharmacy, Peter authorises the sending of a “Dispense Notification” message to the Spine, to allow the updating of Nell’ Medication Record with the supply made so far.  [The ETP System also sets the status of the prescription and item to “partially dispensed”.]

 

Later in the week, Nell returns to Potion’s Pharmacy, and collects the remaining Logynon tablets that have been dispensed ready for her.  Her prescription is now complete.  This is a no-charge item, so despite Nell having no exemption to general prescription charges, she does not pay a charge for this prescription, and the system records this.

 

Now that the full prescription has been dispensed, Peter sends a combined “Dispense Notification and Reimbursement Claim” message to the Spine, to both update Nell’s clinical record, and to claim reimbursement for the dispense event.  On receipt of this message, the ETP  system updates Nell’s  clinical record with the dispensing information, changes the prescription status to “fully dispensed” (i.e. completed) and forwards information on the prescription, the final dispense notification and the reimbursement claim to the reimbursement authority (PPA in P1R2).

 

Unfortunately, because of the partial dispense, Peter has forgotten to check that the correct pack size information is put in the reimbursement claim, so the PPA has to return the claim, with the reason stated.  Peter checks his dispensing record, annotates the claim with the required information, and re-submits the claim, which is now accepted.  No formal acceptance message is sent to the dispenser; it is assumed that, if no further rejection message is received, the claim is accepted and will be paid in the normal way.

 

 

2.3    Prescribe, (Repeat Dispense, Non-Urgent), Nominated Pharmacy, Dispense (with not required), Reimbursement Claim, Claim Accept

 

Mr Gregory Grump has, in the past, been somewhat non-compliant with medical treatment, and recently suffered a myocardial infarction.  His GP, Dr Simon Share, has recently started working partnership with his local community pharmacist, Sarah Sparkle in a medication management programme.  Mr Grump has agreed to be cared for through this programme.  Two months ago, Dr Share authorised (by a non-urgent parent prescription message) a repeat dispensing prescription containing four items of regular medication for Mr Grump, each with a 28 day supply; the prescription authorises a total of 6 dispenses, to cover a six month period. 

 

Today, about three and a half months into this process, Mr Grump needs a further supply of his hypertension medication.  He goes into the Sarah’s pharmacy in the late morning a time when they have both previously agreed would be convenient for them.  He tells Sarah he is running out of both of his “blood pressure tablets - the ‘a’ ones and the ‘e’ ones”.  Sarah has already “pulled down” issue 4 of Mr Grump’s prescription using a Patient Prescription Release Request, and can see that it is over three weeks since he received the last dispensing of his atenolol and enalapril tablets and is therefore clearly within the next dispensing window.  She also notes that he should be due some more aspirin, and asks him about this.  Mr Grump admits that he is probably in need of some more aspirin, but since it is in a bottle rather than blister, and he takes two a day, he doesn’t usually notice until there are none left! 

 

The prescription also allows for a repeat supply of Gaviscon liquid, to relieve Mr Grump’s heartburn; Sarah knows he only suffers from this infrequently, and does not expect him to require this today.  However, she does check with him, but he confirms he still has over half a bottle left, and anyway, he doesn’t like it much, it is so slimy. 

 

Sarah dispenses the atenolol, enalapril and aspirin for Mr Grump, who leaves the pharmacy quite happy. 

 

The practice of this pharmacy is to send the dispense notification as soon as the patient has received the medication, but to process and claim for reimbursement separately.  Therefore, Sarah sends the dispense notification as Mr Grump leaves, noting that the Gaviscon was not dispensed as it was not required by the patient.  Her dispensing system then automatically sends the relevant claim information for this prescription at the end of the day’s work; it knows that Mr Grump is exempt from payment of prescription charges due to his age (74).

 

On receipt of this dispense notification message, the ETP  system updates Mr Grump’s clinical record with the dispensing information, and changes the status for this prescription issue to “fully dispensed” (i.e. completed) even though the Gaviscon was not dispensed, and adds one to the issue number for that repeat dispensing.

 

On receipt of the reimbursement claim information later that night, the ETP System forwards information on the prescription, the dispense notification and the reimbursement claim to the reimbursement authority (PPA in P1R2).

 

The reimbursement authority receives this information, processes it, and sends a system level transport layer acknowledgement to the ETP System.  No formal acceptance message is sent to the dispenser; it is assumed that, if no rejection message is received, the claim is accepted and will be paid in the normal way.

 

 

2.4    Prescribe, Cancel Item, Nominated Pharmacy, Dispense Notification, Reimbursement Claim Information, Claim Accept

The following clinical scenario demonstrates the process for repeat prescription:

 

Dr Kenneth Williams, the senior partner for a GP practice has come into work to find that one of his junior colleagues, Dr Kenneth Connor, has issued a repeat prescription for one of Dr Williams’ patients, Mrs Hattie Jacques, for treatment of angina. This in itself was done correctly as the prescription was issued as part of the agreed practice guidelines for repeat prescriptions. However, Dr Williams has just received the latest laboratory test for Mrs Jacques which shows that she has an early case of Ulcerative Colitis. One of the items on the prescription she has been given is for a re-dispensing of Adalat LA 30mg mr Tablets which could now aggravate Mrs Jacques’ condition.

 

Dr Williams sends a cancel item message with the reason for cancellation, which he enters. The cancel message is sent out to the ETP System.  The prescription has the status “to be dispensed” therefore the item can be cancelled successfully.  The cancel response message sent back to him informs him of this.

 

When Mrs Jacques goes to collect he prescription from Sparkles Pharmacy, Sarah the pharmacist gives her the prescription, but tells her that she has not got the Adalat LA 30mg mr Tablets, because of a possible future problem with these in the light of the new diagnosis.  Sarah advises Mrs Jacques to make an appointment to see Dr Williams to discuss alternative angina treatments, and also for the alternatives for treatment of her colitis.

 

After Hattie has left the pharmacy, Sarah sends the dispense notification, which confirms that the cancelled Adalat item was not dispensed.  Her dispensing system then automatically sends the relevant claim information for this prescription at the end of the day’s work; it knows that Mrs Jacques is exempt from payment of prescription charges due to her age (68).

On receipt of this dispense notification message, the ETP System system updates Mrs Jacques’ clinical record with the dispensing information, and changes the status for this prescription issue to “fully dispensed”.

 

On receipt of the reimbursement claim information later that night, the ETP System forwards information on the prescription, the dispense notification and the reimbursement claim to the reimbursement authority (PPA in P1R2).

 

The reimbursement authority receives this information, processes it, and sends a system level transport layer acknowledgement to the ETP System.  No formal acceptance message is sent to the dispenser; it is assumed that, if no rejection message is received, the claim is accepted and will be paid in the normal way.

 

 

2.5    Prescribe, Cancel Prescription, Non Nominated Pharmacy

The following clinical scenario demonstrates the process for an acute prescription.

 

Dr Indiana Jones sees Mr Michael Caine in his morning surgery.  Mr Caine has recently started to suffer from prostatic hypertrophy, and Dr Jones has decided to start alpha-blocker treatment; he decides to use one of the proprietary “starter packs” designed for this purpose, Hytrin BPH, and he explains this to Mr Caine.

 

He authorises prescription, and Mr Caine leaves with the prescription token.

After Mr Caine has left, Dr Jones realises his clinical system automatically changed the proprietary medication into a generic prescription, which in this particular case, he did not want, because he wanted Mr Caine to have the explicit BPH starter pack.  He goes to his system and sends a Cancellation Request for the incorrect prescription.

 

Unfortunately, Mr Caine has gone straight to his local pharmacy, and the prescription has already been sent to the dispenser; however, the response message states that it has been sent to Potion’s Pharmacy.  Dr Jones picks up the phone and calls Peter Potion, who still has Mr Caine in the pharmacy.  He explains the situation, and between them they organise the correct medication to be given to Mr Caine, who leaves the pharmacy with his prescription as intended.  Peter sends a Dispense Notification message for the original prescription in which the item is stated as “not dispensed as not required”.  The “incorrect” prescription is then “completed” although the patient received no medication from it, and the clinical record can reflect this and the ETP System can process the prescription with a status of “completed”.

 

Dr Jones authorises a new prescription for Mr Caine, which he issues to go direct to Peter, and which is processed in the normal way.

 

 

2.6    Prescribe, Non Nominated Pharmacy, Dispense Return

The following clinical scenario demonstrates the process for a repeat prescription:

 

Mr Walt Disney has contacted Treetops Surgery to request a repeat prescription for his asthma medication.  His doctor, Charles Stuart, authorises the prescription, and the prescription token is printed out.   Walt collects this from the surgery, and hands it in at Potion’s Pharmacy, which he passes on his way to do some shopping.

 

Potion’s Pharmacy sends a Patient Prescription Release Request for Mr Disney, and receives a Patient Prescription Release Response with details of the prescription.  The prescription is for three items, including a Beclomethasone 200microgram/actuation Inhaler, which Potion’s Pharmacy is currently out of stock of.  Peter Potion explains this to Mr Disney.   Mr Disney is not often in this part of Toytown, so it is not easy for him to call back to collect the item, and he has sufficient of the other items to be able to wait for these.  He therefore decides to have the whole prescription dispensed at his local pharmacy on the other side of the town.

 

When Mr Disney has left the pharmacy, Peter sends his prescription “back” to the ETP System, using a Dispense Return message, so that it can be “pulled down” by Mr Disney’s local pharmacy and dispensed in the normal way.

 

 

2.7    Prescribe, Nominated Prescription, Dispense Return, ETP Response (Return Rejection)

The following clinical scenario demonstrates the process for a repeat prescription:

 

Captain Jack Sparrow has a repeat prescription for treatment of his arthritis.  Treetops Surgery sends the repeat prescription to the ETP System, with the Nominated Pharmacy checked, and gives Captain Sparrow the token to collect the prescription.

 

Potion’s Pharmacy is Jack’s Nominated Pharmacy, so when they send their next routine Nominated Pharmacy Release Request, the details of Jack’s prescription are sent in the Release Response message.  The prescription is for two items, some naproxen 500mg tablets and two tubes diclofenac cream.  Unfortunately, there is a manufacturing supply problem with diclofenac cream, and Peter can only supply Captain Jack with half the prescribed amount.  He gives Jack an “owing” slip with the rest of the prescription.  A dispense notification message is sent to the ETP System to update Jack’s clinical record with the supply of the naproxen and the partial supply of the diclofenac cream. 

 

Two weeks later, there is still no more diclofenac cream.  Jack has called back, but cannot get the balance of his prescription.  The locum pharmacist, Paul Pill, mistakenly tries to send the incomplete prescription back to the ETP System using a Dispense Return message, thinking Jack might be able to find a pharmacy that still has some diclofenac cream. 

On receipt of this Dispense Return message, the business logic of the ETP System rejects the Dispense Return, as the prescription has a status of “partially dispensed” and therefore cannot be returned.

 

Back in the pharmacy the next day, Peter Potion realises what has happened.  He phones Captain Jack and explains the problem.  Together they decide that the best option is for Jack to revisit Dr Jones to get a new prescription for a different NSAID cream.  Peter then sends a Dispense Notification message to the ETP System stating that the outstanding balance is not required and has not been dispensed, but that the prescription can now be regarded as “complete”.  He then sends a reimbursement claim for what has been supplied.

 

Note: Should pharmacy systems’ specification make it impossible to send a Dispense Return for a prescription that has already been partially dispensed?

 

 

2.8    Prescribe, Prescription Rejection

The following clinical scenario demonstrates the process for a repeat prescription:

 

Mrs Elsie Old has been suffering from breast cancer, and has been cared for at home by her husband.  She passed away peacefully, with her family round her, late one Thursday evening.  The Hospiscare Nurse was in attendance, and with Mrs Old’s GP, managed all the attendant paperwork for the family.

 

In Treetops Surgery, the next day, a repeat prescription for pain relief for Mrs Old that was requested on the Thursday to cover her weekend pain control, is presented for authorisation.  Dr Connor, who is not Mrs Old’s GP and is therefore not yet aware that she has died, authorises this. The prescription is sent to the ETP System as normal.

 

Even though Mrs Old had died and the prescription should not have been created for her, there is an error found with the prescription. The ETP System attempts to process the prescription but the prescription is rejected and a rejection notification is sent back to Treetops Surgery. A ‘Digital Signature not found’ error is highlighted, which Dr Connor can not explain, However, he is later informed of Mrs Old’s death and therefore does not try to take any further action to create this prescription.

 

 

2.9    Prescribe (non-urgent), Non-Nominated Pharmacy, Release Rejection

The following clinical scenario demonstrates the process for a patient prescription release request from the pharmacy; it could also apply to a nominated pharmacy release request.

 

Ms Bridget Jones has a repeat prescription for ferrous sulphate 200mg tablets to treat her mild anaemia.  Dr Charles Stuart has authorised this, and has marked it as a non-urgent prescription, and therefore it is “held” by the prescribing system until a previously specified “quiet” time for message traffic. 

 

Ms Jones happens to be passing the surgery, and collects the prescription token. 

She also happens to pass by Sparkles Pharmacy, so she decides to go in to get her prescription.  Sarah Sparkle sends a patient prescription release request to the ETP System, using the information from Bridget’s token.

 

Unfortunately, because the prescription has been designated “non-urgent”, it is not yet present on the ETP System, so Sarah receives a Release Response Rejection message.

 

Sarah phones Treetops Surgery, where it is decided to issue a cancellation to the “non-urgent” prescription, and to re-issue a “normal” prescription for Bridget.  They give Sarah the relevant information so that she can pull this down as soon as it has been sent. Sarah can then dispense this for Bridget in the normal way.  (Not shown in the interaction diagram)

 

 

2.10    Prescribe, Nominated Prescription, Dispense Notification, Dispense Notification Rejection

The following clinical scenario demonstrates the process for a repeat prescription:

 

Late last summer, James Bond requested a repeat prescription for his hay fever medication from his doctor, Dr Indiana Jones at Treetops Surgery.  This was sent to the ETP System as usual, and marked as to be sent to Mr Bond’s nominated pharmacy.

 

As usual, Potion’s Pharmacy had sent a request to the ETP System for all the prescriptions with status “to be dispensed” and with their nominated pharmacy as Potion’s Pharmacy; they had received James’ prescription as part of their pull down.

 

Peter had not dispensed the item, as he was not sure when James would next be available to collect the medication - he was often away on business.

 

This spring, James is suffering from hay fever again, and goes into the pharmacy to see if he can collect his prescription from last summer.  The locum pharmacist, Paul Pill, manages to find an undispensed prescription for James, but does not realise that it is no longer valid within the six month validity period.  He therefore dispenses it for James, and sends a Dispense Notification to the ETP System to that effect.

 

However, once the Dispense Notification reaches the ETP System, it calculates the validity period of the prescription, and notes that it is out of date.  It therefore sends a Dispense Notification Rejection message back to Potion’s Pharmacy.

 

Note: pharmacy systems should be designed to prevent this type of error occurring!

 

In order to work this through, since James has the medication, but his Medication Record cannot reflect this, the next day Peter has to contact Treetops Surgery, who send through a new valid prescription, against which a valid dispense notification can be made.  (This is not shown on the interaction diagram).

 

2.11    GP Dispensing

Farmer Giles Muddy visits his GP, Dr Jolly, for a consultation about his increasing back pain.  Since the ibuprofen Mr Muddy has been taking did help originally, Dr Jolly decides to try Mr Muddy on another non-steroidal anti-inflammatory medication, to see if this gives better relief.  Using his clinical system, he authorises an order for a month’s supply of Naproxen 500mg tablets to be taken twice a day with food.  The system sends this order to both the Data Spine with the information that the GP Surgery is the “Nominated Pharmacy” internally, to the dispensing system in the dispensary of the practice, since Farmer Giles lives about 6 miles away from the village where the surgery is located, and the nearest community pharmacy is even further away, in the village down the valley on the coast.

 

The dispensing system in the surgery places nominated prescription release requests at regular intervals through the surgery hours, and therefore receives confirmation of Mr Muddy’s prescription in a prescription pharmacy release response message almost immediately. 

 

Mr Muddy walks through the surgery to the dispensary, where Mrs Lamb, the dispenser, has prepared his medication for him to collect.  Mr Muddy pays his prescription charge and leaves with his medication.  Mrs Lamb’s dispensary system sends a Combined Dispense Notification and Reimbursement Claim Information message to the ETP system, to both update Mr Muddy’s clinical record and to claim payment for the medication supply.

 

2.12    No Claims Notification.

Michael Jackson, the junior pharmacist at Peter Potion’s Pharmacy has received a prescription for Mr Jerome Johnson’s asthma and has dispensed against it. He enters the details of the dispense event onto the pharmacy system.  Because Michael is not the authorised claimant for the pharmacy his entry only creates the Dispense Notification message which the pharmacy sends to the ETP System.

 

Peter Potion, the authorised claimant for the pharmacy returns from holiday a week later and proceeds to catch up on his invoices. He misses the entry for the dispense event on the pharmacy system and consequently does not cause the system to send the Dispense Claim Information message for the dispense event.

 

The ETP System holds onto the Notification message for the 30 days and then sends it’s contents, along with the Prescription information, to the Reimbursement Authority using the Dispense Reimbursement Claim message format.

 

2.13    Prescribe, Non Nominated Pharmacy, Dispense Notification, Dispense Notification (Amendment).

The following clinical scenario demonstrates the process for correcting a dispensing error where the last dispensing event was amended.

 

Mr Anakin Skywalker has contacted Treetops Surgery with symptoms of asthma. His doctor, Dr Kanobi, authorises a prescription for asthma medication. Anakin takes his prescription to Potion’s Pharmacy.

 

Potion’s Pharmacy requests the prescription for the item, Beclomethasone 200microgram/actuation Inhaler, which is dispensed and given to Anakin. A dispense notification message records this event.

 

Later that day, the pharmacist, Peter Potion, realises he has made a mistake with the dispense notification. The dispensed quantity was incorrectly recorded as 2000 actuations instead of 200 actuations!

 

To make an amendment to the previous dispense event, a copy of the previous dispense event information is created with the corrected quantity of 200 actuations. A new dispense notification is submitted with this information. The ‘replacementOf’ reference within this message links this dispense notification with the one that it is replacing.

 

2.14    Prescribe, Dispense Notification, Dispense Notification, Rebuild Dispense History.

The following clinical scenario demonstrates the process for correcting a dispensing error where a series of dispensing events need to be re-submitted to ensure the patient’s medication record is accurate.

 

Mr Ron Burgundy is collecting a prescription from Potion’s Pharmacy. The pharmacy had to order additional stock to fulfil the prescription so Ron has visited the pharmacy twice to collect all his medication. Hence, two dispense notifications have been submitted.

 

Later that day, the pharmacist, Peter Potion, realises he has made a mistake within the first dispense notification for Ron’s prescription with an incorrect dispensed medication item recorded. As a subsequent dispense notification was submitted, the Withdraw ETP Message cannot be used. To correct this error, the dispense history must be rebuilt.

 

The Rebuild Dispense History message is created and submitted. This contains a corrected first dispense notification and the subsequent dispense notification. In both cases, the ‘replacementOf’ reference within the dispense notification links the new dispense notification with the one that it is replacing.

 

2.15    Prescribe, Dispense Notification, Withdraw ETP Message.

The following clinical scenario demonstrates the process for cancelling the last dispensing event is this was sent in error.

 

During a routine dispensing scenario, the pharmacist, Peter Potion, realises he has recorded a dispense notification against the wrong prescription. To correct this error, the Withdraw ETP Message is created and submitted. This contains the ID of the prescription, the ID of the dispense notification to be withdrawn and the reason for the withdraw request.

 

 

 

3    Application Roles

The applications involved in the Medication Management processes play specific roles.  These, along with the interactions associated with each role, are identified below.

 

3.1    Prescribing System - PORX_AR010000UK01

This is a system that can be used:

1. by an authorised prescriber:

   • to place an order for medicinal/therapeutic treatment to be dispensed at any Community Pharmacy.  This is sent to the ETP System, where it is held until required for dispensing. 

   • to inform the ETP System that they have Personally Administered a treatment to a patient, so that the patient's PSIS record can be updated.

2. to receive, directly from the Reimbursement Authority, the details of a claim rejection and reasons why.

3. to resubmit, directly to the Reimbursement Authority, updated Claim Information details so that reimbursement can be finalised.

• Link to Prescribing Systems interactions with ETP

• Link to Prescribing Systems interactions with Reimbursement Authority

3.2    Dispensing System - PORX_AR020000UK01

This is a system that can be used:

1. by an authorised dispenser/pharmacist:

   • to request the download, from the ETP System, of either an individual prescription or a batch of prescriptions in order to dispense against them. 

   • to inform the ETP System that they have dispensed against a prescription, so that the patient's clinical record can be updated.

2. to send payment claim information for a dispense event to the ETP System, for onward transmission to the Reimbursement Authority.

3. to receive, directly from the Reimbursement Authority, the details of a claim rejection and reasons why.

4. to resubmit, directly to the Reimbursement Authority, updated Claim Information details so that reimbursement can be finalised.

• Link to Dispensing Systems interactions with ETP

• Link to Dispensing Systems interactions with Reimbursement Authority

3.3    ETP System - PORX_AR030000UK01

This is the national system that:

1. acts as the broker between the prescribing and dispensing systems, for the prescriptions awaiting dispensing.

    

2. is responsible for updating the individual patient's PSIS record with all the clinical details contained in the following:

   • each prescription received from prescribing systems - (additionally, the whole prescription is archived)

   • each Dispense event received from dispensing systems

• Link to ETP System interactions with Prescribing Systems

• Link to ETP System interactions with Dispensing Systems

• Link to ETP System interactions with Reimbursement Authority

 

3.4    Reimbursement Authority System - PORX_AR040000UK01

This is the system that:

1. receives, from the ETP system, and then processes all claims for reimbursement/payment for services undertaken in the Prescription / Dispensing cycles within Primary Healthcare.

2. can be used to directly inform individual prescribing or dispensing systems that their reimbursement claim has been rejected and why.

3. can be used to receive directly from the prescribing and dispensing systems updated claim information details so that the reimbursement claim process can be successfully concluded.

• Link to Reimbursement Authority interactions with Prescribing Systems

• Link to Reimbursement Authority interactions with Dispensing Systems

• Link to Reimbursement Authority interactions with ETP
   

3.5    PSIS System - PORX_AR000001UK01

This is the system that:

1. receives, from the ETP system, cancellation notifications.

• Link to PSIS System interactions with ETP System

 

 

 

4    Trigger Events

4.1    Parent Prescription - PORX_TE020101UK01

 

Structured Name	Parent Prescription
Type	User based
State Transition	Active

 

The completed Parent Prescription message is sent by the Prescribing System to the ETP System with an urgency value of ‘High’

4.2    Parent Prescription (Non-urgent) - PORX_TE020102UK01

 

Structured Name	Parent Prescription (Non-urgent)
Type	User based
State Transition	Active

 

The completed Parent Prescription message is sent by the Prescribing System to the ETP System with an urgency value of ‘Low’.

4.3    Patient Prescription Release Request - PORX_TE132004UK01

 

Structured Name	Patient Prescription Release Request
Type	User based
State Transition	Active

 

The Dispensing System requests the “pull down” of a single prescription for a single named patient from the ETP System.  The message contains details of the requester, the patient and the “token” to identify the particular prescription in question.

4.4    Patient Prescription Release Response - PORX_TE070103UK01

 

Structured Name	Patient Prescription Release Response
Type	User based
State Transition	Active

 

The ETP System sends the information of the individual prescription for the individual patient to the Dispensing System, such that the prescription can then be dispensed to that patient.

4.5    Nominated Prescription Release Request - PORX_TE060102UK01

 

Structured Name	Nominated Prescription Release Request
Type	User based
State Transition	Active

 

The Dispensing System calls for the release, from the ETP system, of all those prescriptions waiting to be dispensed that were 'Nominated' for dispensing at its site at the time of the prescription creation.   

4.6    Nominated Prescription Release Response - PORX_TE070103UK01

 

Structured Name	Nominated Prescription Release Response
Type	User based
State Transition	Active

 

The ETP System sends information on each of the prescription that it has, with a status of “to be dispensed” for the particular nominated site, in response to a Nominated Prescription Release Request from that Dispensing System.

4.7    Prescription Release Rejection - PORX_TE110101UK01

 

Structured Name	Prescription Release Rejection
Type	User based
State Transition	Active

 

The ETP System notifies a Dispensing System that its request for the release of dispensing information has been rejected. 

4.8    Dispense Proposal Return - PORX_TE100101UK01

 

Structured Name	Dispense Return
Type	User based
State Transition	Active

 

The Dispensing System returns a prescription that was previously “pulled down” for dispensing to the ETP System since the dispensing cannot take place at that dispensing site. This may be for non-clinical reasons (e.g. out of stock - patient going elsewhere etc.).

4.9    Cancel Request - PORX_TE030101UK01

 

Structured Name	Cancel Request
Type	User based
State Transition	Active

 

The Prescribing System sends a Cancel Request message to the ETP System.

4.10    Cancel Response - PORX_TE050101UK01

 

Structured Name	Cancel Response
Type	User based
State Transition	Active

 

The ETP System sends the Cancel Response message to the Prescribing System informing it that the action of the previous Cancel Request has been successful or not.

4.11    Subsequent Cancel Response - PORX_TE050102UK01

 

Structured Name	Subsequent Cancel Response
Type	User based
State Transition	Active

 

The ETP System sends the Subsequent Cancel Response message to the Prescribing System informing it that the action of a previous unsuccessful Cancel Request has been successful as the prescription has been returned as not dispensed in the Dispense Proposal Return Message.

4.12    Dispense Notification - PORX_TE080101UK01

 

Structured Name	Dispense Notification
Type	User based
State Transition	Active

 

The Dispensing System informs the ETP System of the details of a dispensing event, so that the patient’s clinical record can be updated. 

4.13    Dispense Claim Information - PORX_TE090101UK01

 

Structured Name	Reimbursement Claim Information
Type	User based
State Transition	Active

 

The Dispensing System notifies the ETP System of the details of claim information for a previously completed dispense event, such that the ETP System can then send a reimbursement claim to the Reimbursement Authority.

4.14    Dispense Notification with Claim Information - PORX_TE220102UK01

 

Structured Name	Dispense Notification with Reimbursement Claim Information
Type	User based
State Transition	Active

 

The Dispensing System informs the ETP System of the details of a dispensing event, so that the patient’s clinical record can be updated, and additionally, the details of the claim information for that event so that a reimbursement claim can be sent to the Reimbursement Authority.

4.15    Dispense Reimbursement Claim - PORX_TE370101UK01

 

Structured Name	Dispense Reimbursement Claim
Type	User based
State Transition	Active

 

The ETP System transmits to the Reimbursement Authority all the information required for a reimbursement claim to be made for a dispensing event.

4.16    Dispense Reimbursement Claim Reject - PORX_TE150101UK01

 

Structured Name	Dispense Reimbursement Claim Reject
Type	User based
State Transition	Active

 

The Reimbursement Authority notifies a Dispensing System that it's request for reimbursement for a dispensed prescription has been rejected, with reasons for the rejection given.

4.17    Reimbursement Claim Resubmit - PORX_TE090102UK01

 

Structured Name	Reimbursement Claim Resubmit
Type	User based
State Transition	Active

 

The Dispensing System informs the Reimbursement Authority of any additionally required information related to a reimbursement claim previously made for a completed dispense event, such that the Reimbursement Authority can complete the reimbursement process.

4.18    Dispense No Claim Notification - PORX_TE460101UK01

 

Structured Name	Dispense No Claim Notification
Type	User based
State Transition	Active

 

The ETP system informs the Reimbursement Authority of the details of a Dispense Notification that has been received, but for which, 31 days later, the Dispensing System has yet to make a reimbursement claim.

 

4.19    Dispenser Withdraw - PORX_TE510101UK01

 

Structured Name	Dispenser Withdraw
Type	User based
State Transition	Active

 

A withdraw message is sent by the Dispensing System to the ETP System.

4.20    Forward Withdraw Notification- PORX_TE530101UK01

 

Structured Name	Forward Withdraw Notification
Type	User based
State Transition	Active

 

The ETP system informs the PPA of a successful Prescriber or Dispenser Withdraw.

4.21    Rebuild Dispense History - PORX_TE540101UK01

 

Structured Name	Rebuild Dispense History
Type	User based
State Transition	Active

 

A Dispensing System sends the ETP System a Rebuild History.

 

4.22    PSIS Cancellation Notification - PORX_TE000001UK01

 

Structured Name	PSIS Cancellation Notification
Type	User based
State Transition	Active

 

The ETP System successfully cancels a prescription either as a result of receiving a cancellation notification or as a result of a PDS death notification.

 

5    Interaction Diagrams

5.1    Prescribing System - ETP System Interactions

5.2    Dispensing System - ETP System Interactions

5.3    ETP System - Reimbursement Authority System Interactions

5.4    Dispensing System - Reimbursement Authority System Interactions

 

5.5    ETP System - PSIS System Interactions

 

6    Interactions

6.1    Parent Prescription - PORX_IN020101UK31

This is the interaction between the Prescribing System and the ETP System and consists of the transport of the 'Parent Prescription' message in it's 'Urgent' state.

This message supports the business process whereby a medication treatment order system, used by an authorised prescriber, creates a High Priority order for a medication/therapeutic treatment, which is then sent to the ETP System, where it is held until required for dispensing. 

The Parent Prescription message may be for either an acute “one off” treatment, or may authorize one from a series of 'Repeat' or 'Repeat Dispensing' prescriptions.

• A medication order system may not “mix” an order for an acute treatment item with an order for one or more repeat treatment items in the same prescription.

• A medication order system may not “mix” an order for a medicine as a treatment item with an order for an appliance treatment item or an oxygen therapy item in the same prescription.

 

 

Sending Role	Order Placer - GP system	PORX_AR010000UK01
Receiving Role	Order Fulfiller - ETP System	PORX_AR030000UK01
Trigger Event	Authorised user of prescribing system elects to send an electronic prescription	PORX_TE020101UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Control Act Action	MCAI_MT040101UK03
Message Type	Request for medication/therapeutic treatment	PORX_MT132004UK31

 

 

Receiver Responsibilities

Reason	Interaction
An application acknowledgement is sent if because it fails to meet the specified business process logic	MCCI_IN010000UK13

 

6.2    Parent Prescription (Non-Urgent) - PORX_IN020102UK31

This is the interaction between the Prescribing System and the ETP System and consists of the transport of the 'Parent Prescription' message in it's 'Non-Urgent' state.

This message supports the business process whereby a medication treatment order system, used by an authorised prescriber, creates a low priority order for a medication/therapeutic treatment, which is then sent to the ETP System, where it is held until required for dispensing. 

The Parent Prescription message may be for either an acute “one off” treatment, or may authorize one from a series of 'Repeat' or 'Repeat Dispensing' prescriptions.

• A medication order system may not “mix” an order for an acute treatment item with an order for one or more repeat treatment items in the same prescription.

• A medication order system may not “mix” an order for a medicine as a treatment item with an order for an appliance treatment item or an oxygen therapy item in the same prescription.

 

Sending Role	Order Placer	PORX_AR010000UK01
Receiving Role	Order Fulfiller	PORX_AR030000UK01
Trigger Event	Authorised user of prescribing system elects to send a non-urgent electronic prescription	PORX_TE020102UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Control Act Action	MCAI_MT040101UK03
Message Type	Request for medication/therapeutic treatment	PORX_MT132004UK31

 

 

Receiver Responsibilities

Reason	Interaction
An application acknowledgement is sent if because it fails to meet the specified business process logic	MCCI_IN010000UK13

 

6.3    Patient Prescription Release Request - PORX_IN132004UK30

This is an interaction between the Dispensing System and the ETP System and consists of the transport of the 'Patient Prescription Release Request' message.

The message transmits the request from an authorised dispensing system, for the “pull down” of a single prescription for a single named patient to the ETP System.  The message contains details of the requester, the patient and the “token” to identify the particular prescription in question.

 

Sending Role	Order Fulfiller	PORX_AR020000UK01
Receiving Role	Order Placer	PORX_AR030000UK01
Trigger Event	An authorised dispenser calls for prescription(s) for an individual patient (with or without token)	PORX_TE132004UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Control Act Action	MCAI_MT040101UK03
Message Type	Request for information on prescription(s) to dispense for a named patient	PORX_MT121002UK30

 

 

Receiver Responsibilities

Reason	Interaction
Patient Prescription Release Response	PORX_IN070103UK31
Prescription Release Rejection	PORX_IN110101UK30

 

6.4    Patient Prescription Release Response - PORX_IN070103UK31

This is an interaction between the ETP System and a Dispensing System and consists of the transport of the 'Patient Prescription Release Response' message.

This message is used by the ETP System to send the information of the individual prescription for the individual patient to the Dispensing System, such that it can be dispensed to that patient.

• As well as the original prescription information, it contains the status of the prescription and the items on it (always “with dispenser) and information about the patient’s prescription charge exemption status.

 

Sending Role	Order Placer	PORX_AR030000UK01
Receiving Role	Order Fulfiller	PORX_AR020000UK01
Trigger Event	Receipt of a Patient Prescription Release Request.	PORX_TE070103UK01
Transmission Wrapper	Application Acknowledgement	MCCI_MT020101UK12
Control Act Wrapper	Control Act Information	MCAI_MT040101UK03
Message Type	Placing of Prescription Order(s) for Dispensing for an Individual Patient	PORX_MT122002UK31

 

6.5    Nominated Prescription Release Request - PORX_IN060102UK30

This is an interaction between a Dispensing System and the ETP System and consists of the transport of the 'Nominated Prescription Release Request' message.

The message carries the details of the Dispensing System's request for the release, from the ETP system, of all those prescriptions waiting to be dispensed that were 'Nominated' for dispensing at its site at the time of the prescription creation.   

 

Sending Role	Order Fulfiller	PORX_AR020000UK01
Receiving Role	Order Placer	PORX_AR030000UK01
Trigger Event	An authorised dispenser calls for all prescriptions nominated for dispensing at that dispensing site	PORX_TE060102UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Control Act Action	MCAI_MT040101UK03
Message Type	Request for information on prescriptions to dispense for that site	PORX_MT121001UK30

 

 

Receiver Responsibilities

Reason	Interaction
Nominated Prescription Release Response	PORX_IN070101UK31
Prescription Release Rejection	PORX_IN110101UK30

6.6    Nominated Prescription Release Response - PORX_IN070101UK31

This is an interaction between the ETP System and a Dispensing System and consists of the transport of the 'Nominated Prescription Release Response' message.

This message is used by the ETP System to send the details, to a Dispensing System, of the prescriptions that it has waiting with a status of “to be dispensed” for the particular nominated pharmacy site, in response to a Nominated Prescription Release Request from that site.

• Note: The prescriptions are sent in batches, maximum number of 50 prescriptions per batch. Therefore this interaction may occur several times in succession.

 

Sending Role	Order Placer	PORX_AR030000UK01
Receiving Role	Order Fulfiller	PORX_AR020000UK01
Trigger Event	Receipt of a Nominated Prescription Release Request.	PORX_TE070103UK01
Transmission Wrapper	Application Acknowledgement	MCCI_MT020101UK12
Control Act Wrapper	Control Act Information	MCAI_MT040101UK03
Message Type	Placing of Prescription Orders for Dispensing	PORX_MT122002UK31

 

6.7    Prescription Release Rejection - PORX_IN110101UK30

This is an interaction between the ETP System and a Dispensing System and consists of the transport of the 'Prescription Release Rejection' message.

This message is used by the ETP System to notify a Dispensing System that it's request for the release of one or more Parent Prescriptions has been rejected. 

• Note: This is a “generic” message and can be used in both circumstances created by the receipt by the ETP system of either a Patient Prescription Release Request (- a single prescription response) or a Nominated Prescription Release Request ( - a batch prescription response).

 

Sending Role	Placer	PORX_AR030000UK01
Receiving Role	Fulfiller	PORX_AR020000UK01
Trigger Event	On receipt of a Prescription Release Request of either Patient or Nominated variety.	PORX_TE110101UK01
Transmission Wrapper	Application Acknowledgement	MCCI_MT020101UK12
Control Act Wrapper	Control Act Information	MCAI_MT040101UK03
Message Type	Prescription Release Rejection Notification	PORX_MT121201UK30

 

6.8    Dispense Proposal Return - PORX_IN100101UK31

This is an interaction between a Dispensing System and the ETP System and consists of the transport of the 'Dispense Proposal Return' message.

This message is used by the Dispensing System to return a prescription that was previously “pulled down” for dispensing (either as a result of a Nominated Prescription Release Request or a Patient Prescription Release Request) to the ETP System, since the dispensing cannot take place at that dispensing site. This could be for non-clinical reasons (e.g. out of stock - patient going elsewhere etc.).

• The ETP System will then change the Prescription Status from “with dispenser” to  “to be dispensed”, so that it becomes immediately available for another dispenser to “pull down” for dispensing.

 

Sending Role	Placer	PORX_AR020000UK01
Receiving Role	Fulfiller	PORX_AR030000UK01
Trigger Event	Dispenser authorises return of Undispensed Prescription to the ETP System	PORX_TE100101UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Control Act Action	MCAI_MT040101UK03
Message Type	Return of an Undispensed Prescription	PORX_MT121301UK31

 

 

Receiver Responsibilities

Reason	Interaction
An application acknowledgement is sent to inform of the success or failure if it fails to meet the specified business process logic of the Dispense Proposal Return.	MCCI_IN010000UK13

6.9    Cancel Request - PORX_IN030101UK32

This is an interaction between the Prescribing System and the ETP System and consists of the transport of the 'Cancel Request' message.

This message is sent by an authorised person from the prescribing system to the ETP System to attempt to cancel either a whole Prescription or a single Line Item on a prescription before it is dispensed.

 

Sending Role	Order Placer	PORX_AR010000UK01
Receiving Role	Order Fulfiller	PORX_AR030000UK01
Trigger Event	Authorised “canceller” elects to send an electronic cancellation message (for item or prescription)	PORX_TE030101UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Control Act Action	MCAI_MT040101UK03
Message Type	Request to cancel either a whole prescription or a single Line Item on a prescription.	PORX_MT135001UK32

 

 

Receiver Responsibilities

Reason	Interaction
Cancel Response	Cancel Response PORX_IN050101UK31

6.10    Cancel Response - PORX_IN050101UK31

This is an interaction between the ETP System and the Prescribing System and consists of the transport of the 'Cancel Response' message.

This message is sent by the ETP System to the author of a Cancel Request to inform them whether or not the previously requested cancellation for an Item or Prescription has been successfully executed.

 

Sending Role	Informer	PORX_AR030000UK01
Receiving Role	Tracker	PORX_AR010000UK01
Trigger Event	Receipt of a Cancel Request message	PORX_TE050101UK01
Transmission Wrapper	Application Acknowledgement	MCCI_MT020101UK12
Control Act Wrapper	Control Act Action	MCAI_MT040101UK03
Message Type	Informing of the Outcome of a Cancellation Request	PORX_MT135201UK31

 

6.11    Subsequent Cancel Response - PORX_IN050102UK32

This is an interaction between the ETP System and the Prescribing System and consists of the transport of the 'Cancel Response' message.  This message is sent by the ETP System to the author of a Cancel Request informing it that the action of a previous unsuccessful Cancel Request has been successful as the prescription has been returned as not dispensed in the Dispense Proposal Return Message and Dispense Notification Message.

 

Sending Role	Informer	PORX_AR030000UK01
Receiving Role	Tracker	PORX_AR010000UK01
Trigger Event	Receipt of a Dispense Proposal Return message	PORX_TE050102UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Control Act Action	MCAI_MT040101UK03
Message Type	Informing of the Outcome of a Cancellation Request	PORX_MT135201UK31

 

6.12    Dispense Notification - PORX_IN080101UK31

This is an interaction between a Dispensing System and the ETP System and consists of the transport of the 'Dispense Notification' message.

This message is used by the Dispensing System to inform the ETP System of the details of a dispensing event, so that the patient’s clinical record can be updated. 

 

Sending Role	Informer	PORX_AR020000UK01
Receiving Role	Tracker	PORX_AR030000UK01
Trigger Event	A dispensing event has taken place for an individual patient	PORX_TE080101UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Control Act Action	MCAI_MT040101UK03
Message Type	Notification of a Dispense event	PORX_MT024001UK31

 

 

Receiver Responsibilities

Reason	Interaction
An application acknowledgement is sent to inform of failure to meet the specified business process logic of the Dispense Notification.	MCCI_IN010000UK13

 

6.13    Dispense Claim Information - PORX_IN090101UK31

This is an interaction between a Dispensing System and the ETP System and consists of the transport of the 'Dispense Claim Information' message.

This message is used by the Dispensing System to notify the ETP System of the claim information details for a previously completed dispense event, such that the ETP System can then send a Reimbursement Claim to the Reimbursement Authority.

 

Sending Role	Informer	PORX_AR020000UK01
Receiving Role	Tracker	PORX_AR030000UK01
Trigger Event	Decision to send a Reimbursement Claim	PORX_TE090101UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Control Act Action	MCAI_MT040101UK03
Message Type	Reimbursement Claim Information	PORX_MT142001UK31

 

 

Receiver Responsibilities

Reason	Interaction
An application acknowledgement is sent to inform of the failure to meet the specified business process logic of the Dispense Claim Information.	MCCI_IN010000UK13

 

6.14    Dispense Notification with Claim Information - PORX_IN220102UK31

This is an interaction between a Dispensing System and the ETP System and consists of the transport of the 'Dispense Notification with Claim Information' message.

This message is used by the Dispensing System, informing the ETP System of the details of a dispensing event, so that the patient’s clinical record can be updated, and additionally, the details of the claim information for that event so that a reimbursement claim can be sent to the Reimbursement Authority.

 

Sending Role	Informer	PORX_AR020000UK01
Receiving Role	Tracker	PORX_AR030000UK01
Trigger Event	[Final] Completion of a Dispense Event	PORX_TE220102UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Control Act Action	MCAI_MT040101UK03
Message Type	Notification of a Dispensing Event, with	PORX_MT142004UK31

 

 

Receiver Responsibilities

Reason	Interaction
An application acknowledgement is sent to inform of the failure to meet the specified business process logic of the Dispense Notification with Claim Information.	MCCI_IN010000UK13

 

6.15    Dispense Reimbursement Claim - PORX_IN370101UK31

This is an interaction between the ETP System the Reimbursement Authority System and consists of the transport of the 'Dispense Reimbursement Claim' message.

This message is generated by the ETP System and transmits all the information required about a dispensing event so that the Reimbursement Authority can process the reimbursement claim.

 

Sending Role	Order Placer	PORX_AR030000UK01
Receiving Role	Order Fulfiller	PORX_AR040000UK01
Trigger Event	Receipt of Reimbursement Information for a Dispensing Event from a Dispensing System	PORX_TE370101UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Control Act Action	MCAI_MT040101UK03
Message Type	Reimbursement Request	PORX_MT142006UK31

 

6.16    Dispense Reimbursement Claim Reject - PORX_IN150101UK31

This is an interaction between the Reimbursement Authority System and a Dispensing System and consists of the transport of the 'Dispense Reimbursement Claim Reject' message.

This message is used by the Reimbursement Authority to notify a Dispensing System that it's request for reimbursement for a dispensed prescription has been rejected, with reasons for the rejection given.

This is modelled as a response to an original claim submission (or resubmission). The MessageRef.id in the response will contain the UUID of the original request message that triggered ETP to send the claim to the Payment Authority. 

 

Sending Role	Informer	PORX_AR040000UK01
Receiving Role	Tracker	PORX_AR020000UK01
Trigger Event	Receipt of a Dispense Reimbursement Claim message that is unacceptable for reimbursement	PORX_TE150101UK01
Transmission Wrapper	Application Acknowledgment	MCCI_MT020101UK12
Control Act Wrapper	Control Act Information	MCAI_MT040101UK03
Message Type	Invoice Rejection Notification	PORX_MT142201UK31

 

6.17    Reimbursement Claim Resubmit - PORX_IN090102UK31

This is an interaction between the Dispensing System the Reimbursement Authority System and consists of the transport of the 'Dispense Claim Information' message.

This message is used by the Dispensing System to notify the Reimbursement Authority of the further details of information required of a reimbursement claim previously made for a completed dispense event, such that the Reimbursement Authority can complete the reimbursement process.

 

Sending Role	Informer	PORX_AR020000UK01
Receiving Role	Tracker	PORX_AR040000UK01
Trigger Event	Receipt of a Dispense Reimbursement Claim Rejection message	PORX_TE090102UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Control Act Action	MCAI_MT040101UK03
Message Type	Updated Dispense Claim Information	PORX_MT142001UK31

 

6.18    Dispense No Claim Notification - PORX_IN460101UK31

This is an interaction between the ETP System the Reimbursement Authority System and consists of the transport of the 'Dispense Reimbursement Claim' message.

The ETP system informs the Reimbursement Authority of the details of a Dispense Notification that has been received, but for which, 31 days later, the Dispensing System has yet to make a reimbursement claim.

 

Sending Role	Placer	PORX_AR030000UK01
Receiving Role	Fulfiller	PORX_AR040000UK01
Trigger Event	A Dispense Notification message has been with the ETP system for 31 days without an accompanying Dispense Claim Information message being received	PORX_TE460101UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Control Act Information	MCAI_MT040101UK03
Message Type	Dispense Reimbursement Claim	PORX_MT142006UK31

 

 

Receiver Responsibilities

Reason	Interaction
An application acknowledgement is sent to inform of the failure to meet the specified business process logic of the Prescriber Withdraw.	MCCI_IN010000UK13

 

6.19    Dispenser Withdraw - PORX_IN510101UK31

This is an interaction between a Prescribing System and the ETP System  and consists of the transport of the 'Withdraw ETP Message' .

 

Sending Role	Placer	PORX_AR020000UK01
Receiving Role	Fulfiller	PORX_AR030000UK01
Trigger Event	A withdraw message is sent by the Dispensing System to the ETP System	PORX_TE510101UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Control Act Information	MCAI_MT040101UK03
Message Type	Withdraw ETP Message	PORX_MT136001UK31

 

 

Receiver Responsibilities

Reason	Interaction
An application acknowledgement is sent to inform of the success or failure to meet the specified business process logic of the Dispenser Withdraw.	MCCI_IN010000UK13

 

6.20    Forward Withdraw Notification - PORX_IN530101UK31

This is an interaction between the ETP System and the PPA where the ETP System forwards successful withdraw notification messages on to the PPA.

 

Sending Role	Informer	PORX_AR030000UK01
Receiving Role	Tracker	PORX_AR040000UK01
Trigger Event	The ETP system informs the PPA of a successful Prescriber or Dispenser Withdraw	PORX_TE530101UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Control Act Information	MCAI_MT040101UK03
Message Type	Withdraw ETP Message	PORX_MT136001UK31

 

6.21    Rebuild Dispense History - PORX_IN540101UK31

This is an interaction between a Dispensing System and the ETP System  and consists of the transport of the 'Rebuild Dispense History' message to correct incorrect dispensing history stored on the ETP System.

 

Sending Role	Placer	PORX_AR020000UK01
Receiving Role	Fulfiller	PORX_AR030000UK01
Trigger Event	A Dispensing System sends the ETP System a Rebuild History	PORX_TE540101UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Control Act Information	MCAI_MT040101UK03
Message Type	Rebuild Dispense History	PORX_MT136002UK31

 

 

Receiver Responsibilities

Reason	Interaction
An application acknowledgement is sent to inform of the success or failure to meet the specified business process logic of the Rebuild Dispense History.	MCCI_IN010000UK13

 

 

6.22    PSIS Cancellation Notification - PORX_IN000001UK01

This is an interaction between the ETP System and the PSIS where the ETP System forwards successful Prescription Cancellation Notification messages on to the PSIS.

 

Sending Role	Informer	PORX_AR030000UK01
Receiving Role	Tracker	PORX_AR000001UK01
Trigger Event	The ETP system successfully cancels a prescription.	PORX_TE000001UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Control Act Information	MCAI_MT040101UK03
Message Type	PSIS Cancellation Notification	PORX_MT135001UK32

 

 

 

7    Message Definitions

7.1    Parent Prescription - PORX_MT132004UK31

This message transmits the information in an authorised prescription from the Prescribing System to the ETP System. 

It supports the business process whereby a medication/therapeutic treatment order system used by an authorised prescriber places an order for treatment, which is sent to the ETP System, where it is held until required for dispensing. 

The message contains the details of a prescription issued by an authorised prescriber.  A Parent Prescription message may be for either an acute “one off” treatment, or may authorise a one from a series of 'Repeat' or 'Repeat Dispensing' prescriptions.

• A medication order system may not “mix” an order for an acute treatment item with an order for one or more repeat treatment items in the same prescription.

 

               

7.2    Patient Prescription Release Request - PORX_MT121002UK30

This message transmits the request for “pull down” of a single prescription for a single named patient from an authorised Dispensing System to the ETP System.  The message contains details of the requester, the patient and the “token” to identify the particular prescription in question.

 

          

7.3    Nominated Prescription Release Request - PORX_MT121001UK30

This message transmits the request from a dispensing site to call for the release by the ETP System of all those prescriptions waiting "to be dispensed" that have, at the time of the prescription creation, been identified as being able to be dispensed at that site (i.e. Nominated)

 

          

7.4    Prescription Release Response - PORX_MT122002UK31

This message is used by the ETP System to send information on each of the prescriptions that it has with a status of “to be dispensed”. The request for this information may have come from a Nominated Pharmacy or from one which the patient has just presented their ‘token’ to.

This message could carry just one specific prescription or a batch of them. A batch cannot contain more than 50 prescriptions at a time.

 

This message use a technique to support the batching of messages:-

• Click Here for the generic documentation on this approach

• Click Here for the specific documentation relating to Medication Management

 

             

7.5    Prescription Response - PORX_MT122003UK30

This message is used by the ETP System within the Prescription Release Response message to achieve backwards compatibility (ETP 1.5 messages)

 

                

7.6    Prescription Response - PORX_MT122003UK32

This message is used by the ETP System within the Prescription Release Response message to achieve backwards compatibility (ETP 2 messages)

 

                

7.7    Prescription Release Rejection - PORX_MT121201UK30

This message is used by the ETP System to notify a Dispensing System that it's request for the release of a Parent Prescription has been rejected.

 

           

7.8    Dispense Proposal Return - PORX_MT121301UK31

This message is used by the dispensing System to return a prescription that was previously “pulled down” for dispensing (either as a result of a Nominated Pharmacy Release Request or a Patient Prescription Release Request) to the ETP System since the dispensing cannot take place at that dispensing site. This could be for non-clinical reasons (e.g. out of stock - patient going elsewhere etc.).

The ETP System will then change the Prescription Status from “with dispenser” to “to be dispensed”, so that it is immediately available for another dispenser to “pull down” for dispensing.

 

           

7.9    Cancel Request - PORX_MT135001UK32

This message is sent by an authorised person from the Prescribing System to the ETP System to attempt to cancel either an item on a previously sent prescription, or the whole prescription, so that it is not dispensed.

 

                

7.10    Cancel Response - PORX_MT135201UK31

This message is sent by the ETP System to the author of a Cancel message to inform them whether or not the previously requested cancellation for an Item or Prescription has been successfully executed.

 

                

7.11    Dispense Notification - PORX_MT024001UK31

This message is used by the Dispensing System to inform the ETP System of the details of a dispensing event, so that the patient’s clinical record can be updated. 

 

           

7.12    Dispense Claim Information - PORX_MT142001UK31

This message is generated by the Dispensing System and transmits all the information required for a reimbursement claim to be made for a dispensing event from the ETP System to the Reimbursement Authority.

• It can also be used by the Dispensing System to carry the Reimbursement Claim Resubmit information required by the Reimbursement Authority.

 

               

7.13    Dispense Notification with Claim Information - PORX_MT142004UK31

This message is used by the Dispensing System to notify the ETP System of the details of a dispensing event, so that the patient’s clinical record can be updated, and the details of the claim information, so that the ETP System can then send a reimbursement claim for that completed dispensing event to the Reimbursement Authority.

 

               

7.14    Dispense Reimbursement Claim - PORX_MT142006UK31

This message is generated by the ETP System and transmits all the information required of a dispense event so that a reimbursement claim can be made to the Reimbursement Authority.

This message use a technique to support the backwards compatibility of more than one message version:-

• Click Here for the generic documentation on this approach
• Click Here for the specific documentation relating to Medication Management

                

7.15    Dispense Reimbursement Claim Rejection - PORX_MT142201UK31

This message is used by the Reimbursement Authority to notify a Dispensing System that a request for reimbursement for a dispensed prescription has been rejected, with reasons for the rejection given.

 

                

7.16    Withdraw ETP Message - PORX_MT136001UK31

This message is used Dispensing and Prescribing Systems to withdraw messages from the ETP System.

 

               

7.17    Rebuild Dispense History - PORX_MT136002UK31

This message is used by the Dispensing System to send an updated dispensing history to the ETP System.

Cretin messages use a technique to support the batching of messages and the backwards compatibility of more than one message version.

• Click Here for the generic documentation on this approach
• Click Here for the specific documentation relating to Medication Management

 

                

 

 

8    Glossary of Terms

ETP	Electronic Transfer of Prescriptions
PPA	Prescription Pricing Authority