My name is Des Byrne. Thank you for attending. Today I’m going to go through our new product for the Common Conditions Service. I’m

Our name is Refill Assistant. We work exclusively with pharmacies in the US and Ireland, and we’ve been doing that for nearly 10 years. What we’re all about is reducing the pain of too many phone calls and too many interruptions  in the pharmacy.

We’re an Irish company based in Cork, and we have team members around the country — Dublin, Galway, Waterford, and Cork itself. We’re an affiliate partner of the IPU, which means IPU members get discounts for our products.

The way we help improve pharmacy efficiency and make it easier in terms of calls and interruptions is through different online channels. We provide a website and a mobile app, and we make pharmacy services available on those channels. That could be vaccination booking, prescription ordering, repeat reminders, and so on.

Those tools together help improve the pharmacy’s script ordering, communications, and appointment workflow. If you think about how it works, it’s like a self-service model for the patient. They can book a vaccination and complete the screening and medical intake form online. You receive it, review it, and then administer the vaccine.

Or they can receive a refill reminder and submit the prescription to you via the mobile app. It comes into our back office system and you can see it there.

And it’s into that infrastructure that we’ve built the Common Conditions Service tool as well — and I’m going to go on to that now.

So these are the eight common conditions that have been defined so far in the documentation — allergies, cold sores, etc. When we were looking at this early last year, we looked at how many people are affected by these conditions.

Just to give a few examples: allergic rhinitis and conjunctivitis — about 26% of people are affected. Cold sores — about 48% of people are affected. Conjunctivitis has a point prevalence of about 6%, meaning at any one time up to 6% of the population could have it. Impetigo is about 12% in children, depending on crowding. Oral thrush is about 5–7% in young and at-risk groups. Shingles has about a 30% lifetime risk. Cystitis and thrush have a lifetime risk of more than 50% and 75% respectively for women.

Those are the kinds of numbers you’ll find if you search online. But you’ll also have your own understanding of what it’s going to look like in your local demographic and the region your pharmacy serves.

The challenge I see — and we hear this all the time — is that pharmacy is expected to deliver more of these services by the HSE, and like all small businesses you’re constrained in terms of resources. You have to do this with existing staff and time.

That’s where we come in and where we help: we have everything you need to deliver Common Conditions Service consultations efficiently and compliantly from day one.

We do that by eliminating consultation paperwork because it’s all done online. We have a structured workflow with pre-screening and then the consultation questionnaire itself, and we support both walk-ins and bookings. We estimate that the complete tool will save about 5 to 6 minutes per consultation — which is significant time within the pharmacy.

So how do we do that?

First, we have patient pre-screening forms — eight of them — and the patient fills out a pre-screening checklist. These can be used with bookings or appointments. Then the patient comes to the pharmacist, and the pharmacist has a protocol-aligned checklist to go through. As they go through the checklist, they can decide the outcome, make notes, and record that outcome.

From there, they can generate a prescription using the prescription generator, which I’ll show you. Once the consultation is saved, you have an immutable consultation record. And like all of our products, we include a full audit trail and GDPR compliance trail. If you ever need to check anything, you have the audit trail. And of course, we are your data sub-processor — we sign a GDPR processor agreement with you — and we have the full security infrastructure including two-factor authentication and support services for GDPR compliance.

The first thing you’ll notice when you use the service is a new tab in the back office. For those who haven’t used our services before, the back office includes mobile orders, website orders, repeats, messages, statistics, appointments, and then consultations.

When you press the consultations tab, it lists all the consultations you’re working through, and you can start a new consultation from there as well. Starting a new consultation opens up a consultation form for a walk-in. I’ll go through that live in a bit.

The walk-in consultation has a slightly different format in terms of consent compared to a pre-booked consultation.

If you’re already using the booking engine for things like flu vaccines, then when you use the consultation tool, we upgrade the appointment system so that it’s populated with the pre-consultation questionnaire as part of the booking.

You can see an example here for a cold sores consultation. When the appointment time arrives, you press Start Consultation and it opens the consultation record for that patient. You can view the pre-consultation responses from the patient, then complete the checklist and outcomes.

One of the outcomes is prescription generation. The tool includes a prescription generator where you add details about the prescription being issued, and it creates a prescription record in the official format. You can copy and paste that into Healthmail.

We’ve also come up with a solution where we expect we’ll be able to open Healthmail from within the consultation record in Refill Assistant — and then all you’d have to do is paste the prescription and send it from within Healthmail.

So that’s the main part of the slides. Next I’m going to show you a live demo.

Before I do that, I’m going to add a poll. The poll is about what information you’d prefer in the assessment form — what kind of questions you want in it, and any other thoughts.

For this webinar today, I’m using the IAOP training information. The IPU ones came out about a week and a half ago and we haven’t put them in yet. But if there are other things you think about, please add them — that would be great.

Okay, let me close the slideshow and I’ll show you the system in operation.

What you’re seeing now is our back office system — we call it the pharmacy portal. I’ve opened it under consultations, and I’m going to run through a walk-in consultation.

If you’ve used the software before, you’ll recognize mobile orders, website orders, repeat reminders, messaging, statistics, appointments, and so on — and now there’s the consultations tab.

If you have a walk-in and you want to start a new consultation, you press New Consultation, then pick the one you want — let’s do cold sores. Again, I’m using the IAOP training data.

You enter the patient’s name, the date (I’m using the 27th just so it doesn’t get mixed up with another one), the date of birth, and the phone number.

The consent for walk-ins is slightly different to the consent if they booked an appointment online. For a walk-in, the patient gives verbal consent, and the pharmacist records that consent here by checking the box. That allows you to begin the consultation.

The consultation opens for that patient. At the top left, you can see the signs and symptoms for that consultation — and that information comes from the official HSE protocol. It gives the pharmacist a quick overview.

When you scroll down, you have the patient information and the pre-consultation responses. You complete those questions — some are mandatory, some optional depending on how the system is configured.

For example: when did you first notice symptoms? Any treatments already used? Current medications? Sensitivities? Anything else the pharmacist should know?

Then you have the consultation questions for the pharmacist. For example: where are the lesions? For a cold sore, outside the mouth. Does it look like a small cluster or one sore? Has it spread? No spreading beyond the lip area.

Then you record the patient assessment — it’s a cold sore. There’s also a differential diagnosis field (a term used in the IAOP training) that can be used or not. Then you have clinical notes.

If you want to add notes, you can show the recommended items and copy them into your notes. Then you select an outcome — for example, Prescription issued.

I can’t show you the prescription generator live today because I’m on a different machine, but you’ll be able to generate the prescription from within the consultation record.

Then you save the consultation, and when you complete it, it becomes immutable — it’s your record for audit purposes. That’s the overview of a walk-in consultation.

Now I’ll show a booked consultation example. Here’s one I created earlier today — a urinary tract infection consultation for someone who booked it. I’m using today’s date to make it easier to view.

The pre-consultation form is visible on your website, and if you use our mobile app it’s also there. The patient picks the consultation, walks through information about the common conditions service, picks a time, enters their name and date of birth, and then starts the questionnaire.

That questionnaire comes into you as the pre-consultation questionnaire. To save time, I already filled one out earlier. When the patient comes in, you can quickly review the answers and start the consultation from within the appointment.

You can view the consent text — the patient already gave consent earlier on your website. Then the pre-consultation questions are already completed, so the pharmacist doesn’t have to answer them again.

You can add notes, then go through the consultation questions — such as temperature, signs of confusion or lethargy, whether they’re an older adult, and then the patient assessment (for example, uncomplicated lower tract UTI).

Differential diagnosis is listed but not mandatory. You also have clinical notes and pharmacist notes, with up to 1,000 characters available. Signs and symptoms are listed at the top.

You can show medication recommendations and copy them into your notes. Then select Prescription issued, save the consultation, and complete it — and it becomes an immutable record.

We’re still working through the IPU documents in terms of those questions — they aren’t fully formed yet and are currently based on IIOP training data.

Thanks to everyone who answered. The feedback is roughly 40% IAOP and 60% IPU assessment forms — which is about what we expected. I’ll share those results with you now.

Now, I want to show two important parts of the system — because when you’re dealing with patient information, prescriptions, and records, two things become really important: audit logs and GDPR.

To reassure everyone: we are intensely aware of and understand security. Everything in our system is encrypted. We have two-factor authentication to log in. We provide everything you need to protect yourself in the event of any issues. We also have cybersecurity insurance.

Audit logging is a big part of it. Everything in our system becomes part of the audit log — staff actions, patient actions, timestamps — and you can find audit information within the system if you ever need it.

From a GDPR point of view, there are a few things you must be able to do remotely. You must be able to export a customer’s data if they request it, and restrict processing if they request it. We have a full process for that — you follow the steps, find the patient, and you can do that.

We have a common conditions roadmap and we’re investing in this long term. There are additional items on the roadmap beyond workflow, prescription generation, and Healthmail integration.