The ExpertCare Hypertension Prescribing Solution

ExpertCare is a medicines optimisation tool which promotes adherence with NICE guidelines on the management of Hypertension and its comorbidities.

For an average 9,000 patient GP practice ExpertCare can

  • Empower prescribing Nurses and Pharmacists to conduct the majority of hypertension consultations with minimal GP input
  • Reduce GP time spent on hypertension consultations by 328 hours p.a. – an annual saving of £24,000
  • Contribute to a significant reduction in heart attacks and strokes saving the NHS £14,000 annually
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The Hypertension Problem

Hypertension Problemy

For Best Hypertension Outcomes

  • Adhere to NICE guidelines for best possible outcomes
  • Guidelines are long and complex – especially for the 60% with comorbidity
  • This requires significant clinician time – particularly scarce GP time
  • GP numbers decreasing
  • Stagnant practice earnings
  • PHE estimates 12% of ALL GP consultations due to high blood pressure
  • Introducing the solution - ExpertCare
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How ExpertCare Works

Using coded patient data from clinical systems, ExpertCare requires 3 simple steps to help you achieve NICE compliance for every hypertensive patient.

how ExpertCare works
The ExpertCare Benefits
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Sharing the load

Peace of mind, knowing that your nurses and pharmacists are getting it right every time with minimal GP input.

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Improving practice profits

For every 7,400 registered patients saving £20,000 plus on reduced GP manhours.

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Improving patient outcomes

Managing hypertension in compliance with NICE ensures your patients with an improved quality of life.

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Saving healthcare costs

The NHS could save £14,000 p.a. for a 9,000 patient practice by reducing heart attacks & strokes.

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Improving medical jurisprudence

Maintain a treatment audit for each patient demonstrating compliance with NICE.

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A worthwhile investment

For an investment of £1,850 per annum for a 7,400 patient practice, save £20,000 plus per annum – 10 x return.

Frequently Asked Questions

  • What is ExpertCare?

    DXS ExpertCare is an expert system which provides prescribing advice with the dual objectives of controlling the patient’s blood pressure to an appropriate target, whilst also achieving conformance with treatments recommended by NICE for the management of hypertension and relevant comorbidities.

  • What is unique about ExpertCare?

    Unlike other medicine optimisation software which makes recommendations based on one comorbidity at a time, ExpertCare will make a recommendation based on any combination of the following conditions:

    • Diabetes (all types)
    • Proteinuria (defined as an ACR › 30)
    • Angina
    • Myocardial Infarction (recent i.e. ‹ 1year and past i.e. › 1year)
    • Atrial fibrillation
    • Heart failure

    ExpertCare thus overcomes one of the main criticisms of NICE, that the guidelines are monothematic, and therefore difficult to implement in real-world situations where patients have comorbidities.

  • Why have the above conditions been chosen?

    The six conditions listed above have been chosen for the following reasons:

    • They have a significant impact on hypertension treatment decisions
    • NICE makes recommendations on appropriate prescribing for these conditions
    • Hypertension management needs to consider the wider risks conferred by comorbidity

  • Does ExpertCare provide prescribing advice?

    ExpertCare interprets the patient’s coded electronic record to infer the presence of any condition which might influence the treatment of hypertension and provides context sensitive advice taken from the SPC of all drugs used in the treatment of hypertension.

    The clinician is notified of

    • Drug indications, cautions and contraindications
    • Advice on initiation, monitoring and discontinuation
    • Routine dosage advice
    • Dose adjustments required in the presence of renal or hepatic impairment

    However, it is up to the prescriber to evaluate this information based on clinical context. For example, childhood asthma might be a caution to the issue of a beta-blocker whereas current asthma would be a contraindication.

  • What happens if a prescriber wants to keep a drug due to an indication not covered by NICE?

    The prescriber can continue a hypertension drug for any indication but will be asked for a reason which will be recorded for the benefit of future users. Further recommendations by ExpertCare will take into consideration the retained drug. For example, clonidine retained for the prophylaxis of migraine.

  • Does ExpertCare advise on interactions?

    ExpertCare does not duplicate the functionality of the GP healthcare record where interactions are highlighted when a new drug is added. In our next version of ExpertCare, we will add warnings to flag up the risk of bradycardia with certain drug combinations. Similarly, we will also indicate when there is an increased likelihood of hyperkalaemia.

  • What happens if the patient prefers not to take the recommended drug class?

    ExpertCare will record the reason for not taking a drug class to inform future consultations. The clinician can then ask for a further recommendation.

    In this situation, ExpertCare is sophisticated in that it always makes recommendations which support the effective management of relevant comorbidity. For example, a patient with hypertension and atrial fibrillation, who opts not to take a beta-blocker, will be recommended a rate-limiting calcium channel blocker instead.

  • What about CCG preferred drugs within a drug class?

    ExpertCare has the functionality to indicate a drug which belongs to a local formulary.

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Powerful Reporting

You will have access to reports on your hypertensive patients, including those with related comorbidities, that tell you:

  • Levels of Hypertension Compliance and Control before ExpertCare.
  • Levels of Hypertension Compliance and Control after ExpertCare.
  • Hypertensive Patients on incorrect medicines
  • Time spent on hypertension consultations by clinician role
  • Impact of treating in accordance with NICE

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