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Sharing electronic records Lessons from the Emergency Care Summary in Scotland Libby Morris, Clinical e health lead Scottish Government 2nd May 2012 Key Messages – What is the Emergency care Summary? – Evaluation – Progress – Lessons learnt What is ECS? • Emergency Care Summary • Patient information is extracted from GP Practice computer systems • Sent to ECS store twice daily • Explicit Consent to view ECS record • The information is ‘Read only’ and available to Emergency Care Providers Responses of 118 NHS24 clinicians about the value of ECS in the current care episode Response of 118 NHS24 clinicians to the question: Incremental steps • • • • • Discussions Emergency Care Summary Palliative Care Summary Key Information Summary Aims to replace paper based faxing of “Special Notes” from GP Practices • Better than ‘the whole record’ • Structured information and summary box ePCS • electronic Palliative Care Summary • MacMillan Cancer Nurses and Marie Curie led initiative • Contains significant and sensitive information –Resuscitation Status, Preferred Place of Care –Carer Details and Advice for OOH Feedback • • • • Larger special notes free text box Smaller special notes free text box Consent rules clearer User requests – All on one data entry screen – Message when sent – Copy of report filed in record – Messages to user when expired – Must fit in with other business processes Key Information Summary • Contains: – Diagnosis and Problems – Contact / Carer details – Anticipatory Care details • Information only sent with patient consent (in line with Palliative Care Summary) • Where possible, information is already captured in GP Systems 2009 Dumfries and Galloway CHI Patient Banner ( Demographics as CUI standard)_ Adverse events Demographics & Contacts Social & Personal Next of kin Services Involved in care Alerts & Risks Healthcare Encounters Admin & Patient Preferences Carer Details Correspondence Medications & Devices Notifications & Legals Investigations & Results Clinical Notes Observations 3rd Party Documents Notifications & Legal Miscellaneous All records ….Links to other applications…. Clinical History OOH attendances On opening record warning appears to alert clinician Patient with KIS note, KIS summary, ePCS and ECS Year on Year Comparison of Monthly Totals 300,000 250,000 Accesses 200,000 2008 2009 2010 2011 150,000 100,000 50,000 0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year on Year Comparison of Monthly Totals 300,000 250,000 Accesses 200,000 2008 2009 2010 2011 150,000 100,000 50,000 0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year on Year Comparison of Monthly Totals 300,000 250,000 Accesses 200,000 2008 2009 2010 2011 150,000 100,000 50,000 0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year on Year Comparison of Monthly Totals 300,000 250,000 Accesses 200,000 2008 2009 2010 2011 150,000 100,000 50,000 0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Summary • ECS developed in Scotland for 100% • Palliative Care Summary(PCS) gave important feedback • Key Information Summary (KIS) will add more information and include ‘medication prescribed elsewhere’ • Agreed standards are key for sharing • Access for meds reconciliation • Further development continues Lessons Learned… • • • • Incremental approach works for Scotland Cooperation and compromise Joint approach with E, W and NI It’s a concept, not a ‘thing’ • Keep it simple…. • Shared records are difficult but… Not impossible!
