ContactTim Anderson, Clinical Pharmacisttim.anderson@nsft.nhs.ukCall from UK: 01603 421212Call from outside UK: +44 (0)1603 421212Website: www.systemtdm.co.uk

:Connected care

A survey of lithium monitoring frequency in Norfolk in 2000 showed that less than 30% of patients received the ideal recommended four blood tests in a year, with 32% receiving one test only. In addition, 30% of patients had blood results outside the local agreed therapeutic range.

As a result, a Therapeutic Blood Monitoring service (The TDM Database) was introduced in 2003/4. Since that time, national guidelines have been published in regard to the frequency and nature of lithium monitoring. The NHS in England and Wales has also introduced quality measures for lithium monitoring in Primary Care. The e�ect on lithium monitoring rates under SystemTDM when compared to national data is substantial.

PRODUCT FEATURES AND BENEFITS SYSTEM TDM™Licence fee dependent on patient numbers

Established system in mental health

NICE/NPSA compliant

Security

Audit results

Management reports

Online patient access

Set-up support

Web-based

Notifies patient of blood test dates and results

Notifies GP and consultant of blood test results

Produces ‘Clinic’ lists

IT Requirements

Improved NICE/NPSA compliance for PCT/MH Trust

Easily read data

Maintains register of all lithium patients in catchment

Sends blood test reminders to all patients every 3 months

Sends up to three reminders, including direct reports to GP for continued non-attendance

Ensures information, education and access to specialist advice (including online)

Integral with a full shared-care agreement with GPs

Multiple users enabled

Configurable for individual patients

No

Yes

Yes

NHS compliant

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

IE7

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

:INTRODUCTION

DATABASE BROCHURE ROLL FOLD AW.indd 1-3 26/09/2011 15:05

Norfolk and SuffolkNHS Foundation Trust

© Copyright 2000-2012. NSFT. SystemTDM software and literature are protected by copyright law and designright. SystemTDM is a registered trademark. All rights reserved.

Our partners:SystemTDM™ is proud to be supported by the UKs largest charity for bi-polar people, bipolarUK. bipolarUK endorses SystemTDM™ as best practice for bipolar su�erers taking lithium.

To learn more about bipolarUK go to www.mdf.org.uk

:CASE STUDY // Lithium monitoring in Norfolk since 2003

SYSTEM TDM SHOWS CLEAR IMPROVEMENT OVERNATIONAL PRACTICE

SystemTDM™ shows clear improvement over Prescribing Observatory for Mental Health (POMH) audit results (i.e. national practice). Compared to the quality and amount of lithium monitoring in Norfolk, over 80% of patients tested at least three times per year with 95% at NICE minimum frequency standards. This result clearly outperforms national survey results, which show only 48% of patients receiving three or more tests and over 30% of patients receiving one test or less.

1 or less

POMH surveyNorfolk before databaseNorfolk after database

2 3 or more

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

0%

NU

MB

ER P

ER Y

EAR

(PA

TIEN

TS O

R T

ESTS

)

1999

n=3+ tests pa2 tests pa1 test pa

2003 2004 2009

1600

1400

1200

1000

800

600

400

200

0

SYSTEM TDM PRODUCED A LARGE IMPROVEMENT

RESULTS OF THE SYSTEM TDM ON LITHIUM MONITORING RATES IN NORFOLK

EFFECT OF SYSTEM TDM ON LITHIUM TESTING IN NORFOLK

IN LITHIUM MONITORING FREQUENCY

SystemTDM™ produced a large improvement in monitoring frequency over previous local practice, and has enabled maintenance of lithium usage in Norfolk.

Prior to introducing the system in 1999, only around 700 out of 1500 patients attended for their three tests per year. After the introduction of the database system in 2003, around 1000 out of 1300 patients have regularly attended three tests per year.

The generation of automatic reminders for patients is key in triggering higher rates of appointments, and ensures patients are involved in their own care. The system also generates alerts to GPs if patients fail to respond to reminders, enabling GPs to be proactive in patient care.

The Prescribing Observatory for Mental Health (POMH) audit shows there were zero adverse safety reports in Norfolk during the reporting period. The expected number for Norfolk based on reported rates for similar catchments is 35.

CONCLUSION:Active management of lithium monitoring using SystemTDM™ shows a marked improvement in performance over the long term. The system is e�ective, cost-efficient and helps improve patient care. In Norfolk, over 80% of patients tested at least three times per year, with 95% at NICE minimum frequency standards.

• Currently 1500 registered users

• Over 5000 registered users since inception

• Maintains register of all people taking lithium in Norfolk

• Send lithium blood test reminders to all patients every 3 months

• Sends up to three reminders, the third alerting the GP directly

• Ensures adequate information, education and access to specialist advice

• Is integral with a full shared-care agreement

FIND OUT MORE:Contact Tim Anderson, Clinical Pharmacisttim.anderson@nsft.nhs.ukCall from UK: 01603 421212Call from outside UK: +44 (0)1603 421212

The National Patient Safety Agency (NPSA) issued an alert on lithium monitoring in December 2009 in response to high levels of incident reporting of lithium related events. This guidance (NPSA) refers to National Institute of Clinical Excellence (NICE) Clinical Guidance 38: Bipolar Disorder monitoring parameters for lithium.

The NPSA guidelines are:

• Monitoring according to NICE Guidelines

• Reliable systems for test results between labs and prescribers

• Initiation with appropriate verbal and written information

• Blood tests monitored regularly, no repeats without safe testing assured

• Systems to detect drug-drug interaction

:CASE STUDY (cont.)

Drug Monitoring system An o�-the-shelf Therapeutic

developed by the NHS, for the NHS.

• Enables GPs and pharmacists to monitor and manage patients being prescribed therapeutic and high cost drugs

• NHS developed; reliable, secure, safe – NHS compliant since 2003

• Improves safety and reduces incidents; improves monitoring outcomes

• Cost e�ective and efficient

• Eliminates need to develop in-house systems at high cost

• Connects primary and secondary care; improves communications across care pathways

• Accessed by GPs and pharmacy consultants and District and General Hospital pharmacy services

• Involves patients in their own care

• Simple to set up, easy to use

• Meets National Patient Safety Advisory (NPSA) requirements

CliniciansHospital

GPNurse Practitioner

RequestingDoctor

PathologyLaboratory

Patient TestPatient

involvementin care

GPPatient information

Access resultsConfigurable

ClinicalPharmacy

SystemTDMNPSA CompliantNICE guidance

compliant

CommissionerNPSA compliance

AssuranceCost e�ective

E�cient

PharmacistsNPSA Compliant

Web-based accessDispensing

REMINDER

RESULT

REPORTING

NOTIFICATIONOUT OFRANGE ALERT

RESULT

NON–RESULT ATTENDANCE

ALERTS

DATABASE BROCHURE ROLL FOLD AW.indd 4-6 26/09/2011 15:05

SYSTEM TDM HAS REDUCED THE NUMBER OFLITHIUM-RELATED SUIs IN NORFOLK TO ZERO

OVERVIEW OF NORFOLK LITHIUM DATABASE ACTIVITY

THE DATABASE PROCESS & UKNATIONAL GUIDELINES

% O

F P

ATI

ENTS

SERUM LITHIUM TESTS PER ANNUM

Norfolk and SuffolkNHS Foundation Trust

:CASE STUDY // Lithium monitoring in Norfolk since 2003

SYSTEM TDM SHOWS CLEAR IMPROVEMENT OVERNATIONAL PRACTICE

SystemTDM™ shows clear improvement over Prescribing Observatory for Mental Health (POMH) audit results (i.e. national practice). Compared to the quality and amount of lithium monitoring in Norfolk, over 80% of patients tested at least three times per year with 95% at NICE minimum frequency standards. This result clearly outperforms national survey results, which show only 48% of patients receiving three or more tests and over 30% of patients receiving one test or less.

1 or less

POMH surveyNorfolk before databaseNorfolk after database

2 3 or more

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

0%

NU

MB

ER P

ER Y

EAR

(PA

TIEN

TS O

R T

ESTS

)

1999

n=3+ tests pa2 tests pa1 test pa

2003 2004 2009

1600

1400

1200

1000

800

600

400

200

0

SYSTEM TDM PRODUCED A LARGE IMPROVEMENT

RESULTS OF THE SYSTEM TDM ON LITHIUM MONITORING RATES IN NORFOLK

EFFECT OF SYSTEM TDM ON LITHIUM TESTING IN NORFOLK

IN LITHIUM MONITORING FREQUENCY

SystemTDM™ produced a large improvement in monitoring frequency over previous local practice, and has enabled maintenance of lithium usage in Norfolk.

Prior to introducing the system in 1999, only around 700 out of 1500 patients attended for their three tests per year. After the introduction of the database system in 2003, around 1000 out of 1300 patients have regularly attended three tests per year.

The generation of automatic reminders for patients is key in triggering higher rates of appointments, and ensures patients are involved in their own care. The system also generates alerts to GPs if patients fail to respond to reminders, enabling GPs to be proactive in patient care.

The Prescribing Observatory for Mental Health (POMH) audit shows there were zero adverse safety reports in Norfolk during the reporting period. The expected number for Norfolk based on reported rates for similar catchments is 35.

CONCLUSION:Active management of lithium monitoring using SystemTDM™ shows a marked improvement in performance over the long term. The system is e�ective, cost-efficient and helps improve patient care. In Norfolk, over 80% of patients tested at least three times per year, with 95% at NICE minimum frequency standards.

• Currently 1500 registered users

• Over 5000 registered users since inception

• Maintains register of all people taking lithium in Norfolk

• Send lithium blood test reminders to all patients every 3 months

• Sends up to three reminders, the third alerting the GP directly

• Ensures adequate information, education and access to specialist advice

• Is integral with a full shared-care agreement

FIND OUT MORE:Contact Tim Anderson, Clinical Pharmacisttim.anderson@nsft.nhs.ukCall from UK: 01603 421212Call from outside UK: +44 (0)1603 421212

The National Patient Safety Agency (NPSA) issued an alert on lithium monitoring in December 2009 in response to high levels of incident reporting of lithium related events. This guidance (NPSA) refers to National Institute of Clinical Excellence (NICE) Clinical Guidance 38: Bipolar Disorder monitoring parameters for lithium.

The NPSA guidelines are:

• Monitoring according to NICE Guidelines

• Reliable systems for test results between labs and prescribers

• Initiation with appropriate verbal and written information

• Blood tests monitored regularly, no repeats without safe testing assured

• Systems to detect drug-drug interaction

:CASE STUDY (cont.)

Drug Monitoring system An o�-the-shelf Therapeutic

developed by the NHS, for the NHS.

• Enables GPs and pharmacists to monitor and manage patients being prescribed therapeutic and high cost drugs

• NHS developed; reliable, secure, safe – NHS compliant since 2003

• Improves safety and reduces incidents; improves monitoring outcomes

• Cost e�ective and efficient

• Eliminates need to develop in-house systems at high cost

• Connects primary and secondary care; improves communications across care pathways

• Accessed by GPs and pharmacy consultants and District and General Hospital pharmacy services

• Involves patients in their own care

• Simple to set up, easy to use

• Meets National Patient Safety Advisory (NPSA) requirements

CliniciansHospital

GPNurse Practitioner

RequestingDoctor

PathologyLaboratory

Patient TestPatient

involvementin care

GPPatient information

Access resultsConfigurable

ClinicalPharmacy

SystemTDMNPSA CompliantNICE guidance

compliant

CommissionerNPSA compliance

AssuranceCost e�ective

E�cient

PharmacistsNPSA Compliant

Web-based accessDispensing

REMINDER

RESULT

REPORTING

NOTIFICATIONOUT OFRANGE ALERT

RESULT

NON–RESULT ATTENDANCE

ALERTS

DATABASE BROCHURE ROLL FOLD AW.indd 4-6 26/09/2011 15:05

SYSTEM TDM HAS REDUCED THE NUMBER OFLITHIUM-RELATED SUIs IN NORFOLK TO ZERO

OVERVIEW OF NORFOLK LITHIUM DATABASE ACTIVITY

THE DATABASE PROCESS & UKNATIONAL GUIDELINES

% O

F P

ATI

ENTS

SERUM LITHIUM TESTS PER ANNUM

Norfolk and SuffolkNHS Foundation Trust

:CASE STUDY // Lithium monitoring in Norfolk since 2003

SYSTEM TDM SHOWS CLEAR IMPROVEMENT OVERNATIONAL PRACTICE

SystemTDM™ shows clear improvement over Prescribing Observatory for Mental Health (POMH) audit results (i.e. national practice). Compared to the quality and amount of lithium monitoring in Norfolk, over 80% of patients tested at least three times per year with 95% at NICE minimum frequency standards. This result clearly outperforms national survey results, which show only 48% of patients receiving three or more tests and over 30% of patients receiving one test or less.

1 or less

POMH surveyNorfolk before databaseNorfolk after database

2 3 or more

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

0%

NU

MB

ER P

ER Y

EAR

(PA

TIEN

TS O

R T

ESTS

)

1999

n=3+ tests pa2 tests pa1 test pa

2003 2004 2009

1600

1400

1200

1000

800

600

400

200

0

SYSTEM TDM PRODUCED A LARGE IMPROVEMENT

RESULTS OF THE SYSTEM TDM ON LITHIUM MONITORING RATES IN NORFOLK

EFFECT OF SYSTEM TDM ON LITHIUM TESTING IN NORFOLK

IN LITHIUM MONITORING FREQUENCY

SystemTDM™ produced a large improvement in monitoring frequency over previous local practice, and has enabled maintenance of lithium usage in Norfolk.

Prior to introducing the system in 1999, only around 700 out of 1500 patients attended for their three tests per year. After the introduction of the database system in 2003, around 1000 out of 1300 patients have regularly attended three tests per year.

The generation of automatic reminders for patients is key in triggering higher rates of appointments, and ensures patients are involved in their own care. The system also generates alerts to GPs if patients fail to respond to reminders, enabling GPs to be proactive in patient care.

The Prescribing Observatory for Mental Health (POMH) audit shows there were zero adverse safety reports in Norfolk during the reporting period. The expected number for Norfolk based on reported rates for similar catchments is 35.

CONCLUSION:Active management of lithium monitoring using SystemTDM™ shows a marked improvement in performance over the long term. The system is e�ective, cost-efficient and helps improve patient care. In Norfolk, over 80% of patients tested at least three times per year, with 95% at NICE minimum frequency standards.

• Currently 1500 registered users

• Over 5000 registered users since inception

• Maintains register of all people taking lithium in Norfolk

• Send lithium blood test reminders to all patients every 3 months

• Sends up to three reminders, the third alerting the GP directly

• Ensures adequate information, education and access to specialist advice

• Is integral with a full shared-care agreement

FIND OUT MORE:Contact Tim Anderson, Clinical Pharmacisttim.anderson@nsft.nhs.ukCall from UK: 01603 421212Call from outside UK: +44 (0)1603 421212

The National Patient Safety Agency (NPSA) issued an alert on lithium monitoring in December 2009 in response to high levels of incident reporting of lithium related events. This guidance (NPSA) refers to National Institute of Clinical Excellence (NICE) Clinical Guidance 38: Bipolar Disorder monitoring parameters for lithium.

The NPSA guidelines are:

• Monitoring according to NICE Guidelines

• Reliable systems for test results between labs and prescribers

• Initiation with appropriate verbal and written information

• Blood tests monitored regularly, no repeats without safe testing assured

• Systems to detect drug-drug interaction

:CASE STUDY (cont.)

Drug Monitoring system An o�-the-shelf Therapeutic

developed by the NHS, for the NHS.

• Enables GPs and pharmacists to monitor and manage patients being prescribed therapeutic and high cost drugs

• NHS developed; reliable, secure, safe – NHS compliant since 2003

• Improves safety and reduces incidents; improves monitoring outcomes

• Cost e�ective and efficient

• Eliminates need to develop in-house systems at high cost

• Connects primary and secondary care; improves communications across care pathways

• Accessed by GPs and pharmacy consultants and District and General Hospital pharmacy services

• Involves patients in their own care

• Simple to set up, easy to use

• Meets National Patient Safety Advisory (NPSA) requirements

CliniciansHospital

GPNurse Practitioner

RequestingDoctor

PathologyLaboratory

Patient TestPatient

involvementin care

GPPatient information

Access resultsConfigurable

ClinicalPharmacy

SystemTDMNPSA CompliantNICE guidance

compliant

CommissionerNPSA compliance

AssuranceCost e�ective

E�cient

PharmacistsNPSA Compliant

Web-based accessDispensing

REMINDER

RESULT

REPORTING

NOTIFICATIONOUT OFRANGE ALERT

RESULT

NON–RESULT ATTENDANCE

ALERTS

DATABASE BROCHURE ROLL FOLD AW.indd 4-6 26/09/2011 15:05

SYSTEM TDM HAS REDUCED THE NUMBER OFLITHIUM-RELATED SUIs IN NORFOLK TO ZERO

OVERVIEW OF NORFOLK LITHIUM DATABASE ACTIVITY

THE DATABASE PROCESS & UKNATIONAL GUIDELINES

% O

F P

ATI

ENTS

SERUM LITHIUM TESTS PER ANNUM

Norfolk and SuffolkNHS Foundation Trust

ContactTim Anderson, Clinical Pharmacisttim.anderson@nsft.nhs.ukCall from UK: 01603 421212Call from outside UK: +44 (0)1603 421212Website: www.systemtdm.co.uk

:Connected care

A survey of lithium monitoring frequency in Norfolk in 2000 showed that less than 30% of patients received the ideal recommended four blood tests in a year, with 32% receiving one test only. In addition, 30% of patients had blood results outside the local agreed therapeutic range.

As a result, a Therapeutic Blood Monitoring service (The TDM Database) was introduced in 2003/4. Since that time, national guidelines have been published in regard to the frequency and nature of lithium monitoring. The NHS in England and Wales has also introduced quality measures for lithium monitoring in Primary Care. The e�ect on lithium monitoring rates under SystemTDM when compared to national data is substantial.

PRODUCT FEATURES AND BENEFITS SYSTEM TDM™Licence fee dependent on patient numbers

Established system in mental health

NICE/NPSA compliant

Security

Audit results

Management reports

Online patient access

Set-up support

Web-based

Notifies patient of blood test dates and results

Notifies GP and consultant of blood test results

Produces ‘Clinic’ lists

IT Requirements

Improved NICE/NPSA compliance for PCT/MH Trust

Easily read data

Maintains register of all lithium patients in catchment

Sends blood test reminders to all patients every 3 months

Sends up to three reminders, including direct reports to GP for continued non-attendance

Ensures information, education and access to specialist advice (including online)

Integral with a full shared-care agreement with GPs

Multiple users enabled

Configurable for individual patients

No

Yes

Yes

NHS compliant

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

IE7

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

:INTRODUCTION

DATABASE BROCHURE ROLL FOLD AW.indd 1-3 26/09/2011 15:05

Norfolk and SuffolkNHS Foundation Trust

© Copyright 2000-2012. NSFT. SystemTDM software and literature are protected by copyright law and designright. SystemTDM is a registered trademark. All rights reserved.

Our partners:SystemTDM™ is proud to be supported by the UKs largest charity for bi-polar people, bipolarUK. bipolarUK endorses SystemTDM™ as best practice for bipolar su�erers taking lithium.

To learn more about bipolarUK go to www.mdf.org.uk

ContactTim Anderson, Clinical Pharmacisttim.anderson@nsft.nhs.ukCall from UK: 01603 421212Call from outside UK: +44 (0)1603 421212Website: www.systemtdm.co.uk

:Connected care

A survey of lithium monitoring frequency in Norfolk in 2000 showed that less than 30% of patients received the ideal recommended four blood tests in a year, with 32% receiving one test only. In addition, 30% of patients had blood results outside the local agreed therapeutic range.

As a result, a Therapeutic Blood Monitoring service (The TDM Database) was introduced in 2003/4. Since that time, national guidelines have been published in regard to the frequency and nature of lithium monitoring. The NHS in England and Wales has also introduced quality measures for lithium monitoring in Primary Care. The e�ect on lithium monitoring rates under SystemTDM when compared to national data is substantial.

PRODUCT FEATURES AND BENEFITS SYSTEM TDM™Licence fee dependent on patient numbers

Established system in mental health

NICE/NPSA compliant

Security

Audit results

Management reports

Online patient access

Set-up support

Web-based

Notifies patient of blood test dates and results

Notifies GP and consultant of blood test results

Produces ‘Clinic’ lists

IT Requirements

Improved NICE/NPSA compliance for PCT/MH Trust

Easily read data

Maintains register of all lithium patients in catchment

Sends blood test reminders to all patients every 3 months

Sends up to three reminders, including direct reports to GP for continued non-attendance

Ensures information, education and access to specialist advice (including online)

Integral with a full shared-care agreement with GPs

Multiple users enabled

Configurable for individual patients

No

Yes

Yes

NHS compliant

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

IE7

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

:INTRODUCTION

DATABASE BROCHURE ROLL FOLD AW.indd 1-3 26/09/2011 15:05

Norfolk and SuffolkNHS Foundation Trust

© Copyright 2000-2012. NSFT. SystemTDM software and literature are protected by copyright law and designright. SystemTDM is a registered trademark. All rights reserved.

Our partners:SystemTDM™ is proud to be supported by the UKs largest charity for bi-polar people, bipolarUK. bipolarUK endorses SystemTDM™ as best practice for bipolar su�erers taking lithium.

To learn more about bipolarUK go to www.mdf.org.uk