NTS introduces new antimicrobial solution

TORONTO – North West Telepharmacy Solutions (NTS), one of Canada’s leading providers of remote pharmacy services, has announced a strategic collaboration with Australian-based Kraken Coding to bring its Clinical Branches software platform into the Canadian healthcare landscape, beginning with its Antimicrobial Stewardship Program (NTS ASP).

The partnership aims to supercharge NTS’s national tele-stewardship initiative by embedding clinical decision support and patient prioritization tools directly into pharmacist workflows.

The first wave of implementation is already under way at select rural hospitals in Ontario facilities without full-time antimicrobial stewardship pharmacists on-site.

“Good stewardship is about timing, trust, and triage,” said Eli Tran, antimicrobial stewardship pharmacist at NTS and one of the clinical leads for the rollout. “Clinical Branches allows us to do real-time prioritization of stewardship work. In rural hospitals where time and resources can be especially limited, Clinical Branches helps to guide our workflow and attention to the patients who need it most.”

Originally launched in 2013, NTS’s antimicrobial stewardship program was re-engineered in late 2024 to help smaller hospitals combat rising rates of antimicrobial resistance.

Many of these facilities face systemic staffing shortages, including limited access to ID-trained pharmacists and physicians, but on-site antimicrobial use is nevertheless high.

Remote stewardship fills that void with telepharmacists collaborating with on-site physicians and nurses to optimize antimicrobial use, recommend alternatives, de-escalate where appropriate, and educate care teams, including on-site pharmacists.

But until now, that work has depended heavily on manual processes and time-intensive data review.

That’s where Kraken Coding’s Clinical Branches platform comes in. Built on branching logic and driven by local treatment guidelines, the software allows pharmacists to create tailored pathways that guide antibiotic decisions and flag patients at higher risk for complications or inappropriate therapy.

The platform integrates with EMRs or can be run standalone with manual data uploads, making it particularly well-suited to Canada’s fragmented digital health infrastructure.

Sammu Dhaliwall (pictured), senior manager of business development, research, and health innovation at NTS, sees the tool as a critical bridge between evidence and efficiency.

“The technology solves a real operational problem,” Dhaliwall said. “We need to be able to prioritize our interventions, especially in hospitals where one remote pharmacist might be supporting multiple sites. Clinical Branches gives us that line of sight into which patients need us most. It helps us deliver smarter care, not just more care.”

As part of the partnership, Kraken is customizing decision support rules based on Canadian antimicrobial protocols and local antibiograms. During the pilot, pharmacists will test both the prescribing guidance and the post-prescription review capabilities, which automatically generate performance dashboards and support quality improvement initiatives.

Kraken CEO John Shanks said the company has been eager to collaborate with a Canadian partner deeply embedded in rural healthcare.

“We’ve seen the power of Clinical Branches to transform prescribing in public and private systems internationally,” said Shanks. “But what makes this pilot special is the mission. NTS is reaching patients and prescribers that traditional stewardship programs often miss. They’re proving that excellence in prescribing isn’t a luxury for big urban hospitals, it’s a right for every patient, everywhere.”

Already, feedback from participating hospitals has been overwhelmingly positive. According to Tran, over 90% of stewardship recommendations made through the NTS program are accepted by physicians and on-site pharmacists are consistently happy with the work NTS ASP has done – a testament to the trust and collaboration built over time.

With Clinical Branches, the team expects even greater precision in matching interventions to the patients who need them most.

“It’s not just about providing stewardship reviews,” Tran added. “It’s about helping rural teams feel supported. This platform enhances our ability to deliver care in the confines of the rural hospital landscape in Canada, allowing us to easily prioritize clinical duties and making data collection in stewardship a less onerous task. The clinical decision support also empowers on-site pharmacists who don’t have experience in stewardship.”

NTS plans to evaluate key metrics such as length of stay, readmission rates, and pharmacist interventions pre and post-implementation. If successful, the Clinical Branches platform could be deployed across the company’s 100+ hospital partners nationwide.

For Dhaliwall, the partnership represents more than just software.

“It’s about showing what’s possible when innovation meets need. We’re not waiting for the future of pharmacy to arrive, we’re building it now, from the ground up, with the tools that rural teams deserve.”

About North West Telepharmacy Solutions
North West Telepharmacy Solutions is Canada’s largest provider of remote pharmacy services, delivering 24/7 clinical pharmacy support to over 100 hospitals, clinics, and health organizations across the country. Founded in 2004, NTS specializes in virtual medication order review, pharmacist-led clinics, and rural workforce innovation, ensuring safe and timely care for patients in regions where onsite pharmacists may not be available. Its services span antimicrobial stewardship, medication reconciliation, opioid safety, and chronic disease management, all delivered by licensed pharmacists and pharmacy technicians integrated into local care teams. To learn more, visit www.northwesttelepharmacy.ca.

About Kraken Coding
Kraken Coding is a health technology company developing clinical decision support tools that meet the practical needs of frontline healthcare staff. Its flagship platform, Clinical Branches, supports best practice antimicrobial prescribing by providing structured decision support pathways which make prescribing easier and inform decision support algorithms to prioritise pharmacist workflows. Designed for flexibility, it works with or without EMR integration and is currently used in 72 hospitals to enable remote stewardship and improve care delivery. Kraken Coding is ISO 27001/27017 cybersecurity certified and partners with clinicians and health systems to deliver safer, more efficient care at scale. To learn more please visit www.krakencoding.com.