Transcript Power Point Presentation

Emergency Care Summary
Dunblane
November hb2008
NHS in Scotland
• 14 Health Boards
– Primary and
Secondary Care
• 1030 Practices
– GPASS, InPS, EMIS,
Ascribe
• 1 National Ambulance
Board
• Scottish Government
Health Department
Agreed Dataset
• Patient demographics (address, telephone,
CHI number)
• Allergies and Adverse Reactions to
medications
• Medication history
- Repeat prescriptions in past 12 months
- Acute prescriptions in past 30 days
• Consent Flag
– Patient opt out status
Progress to Date
• ECS Service pilot started in 2004
• National ECS launched in Sept 2006
• 98.5% of Scottish GP Practices
connected
• Full Integration and rollout:
– NHS24
– OOH
• ECS available in A+E for 12 out of 14
Health Boards
• National Cross Border Access across
all Health Boards in Scotland
Progress to Date
• Over 5.2 Million Patient Records
extracted
• 1400 patients have ‘opted out’ of
practices connected
– Represents 0.02% of all patients
• Over 1.5 million accesses to date and
increasing trend in use
• Expected increase in use as new
developments are available
Users of ECS
• Over 5000 registered users (not
including GP, Administrators or Audit)
• Access controlled through Local System
Administrators in each Health Board
• System to system integration in place
for:
– Adastra and Taycare OOH
– NHS24
– A+E Integration due in 2008
• Web access for Audit
– A+E, OOH Admin, System admin (per
NHS Board)
Consent Model
• Implicit consent to extract / send the data
– Regular extract and update of
information
• Explicit Consent to view ECS record
• Patients can Opt Out / In at any time
– Simple flag on GP Practice System
• ECS information is read only
• Only available to Emergency Care
Clinicians
ECS Security and Audit
• Access and security controls with
passwords and log on for all clinicians
• Patients must give permission for the
clinician to view their records
• Practices can check who has accessed
their patients’ records
• Audit controls in place for:
– Practice Reporting
– Health Board Audit
– Cross Border Audit
– National Audit
ECS Security and Audit
• National Audit checks include:
– Unsuccessful log in attempts
– Casual Browsing / suspicious behaviour
– Long periods worked (trap sharing of
passwords)
– Check on practice files structure
– National Access Protocols
– Refresh of training information for Local
System Administrators
ECS Access Report
Palliative Care Summary
• Macmillan Nurses led initiative
• Palliative Care Forms
– Based on Gold Standards
Framework Scotland (GSFS)
– Paper process already in place in
many GP Practices
– IT Development to assist with key
patient group
GSFS Solution
• Extension to ECS dataset to include more
detailed information to send to OOH for
Palliative Care patients (known as PCS)
• Move from paper to electronic information
• Reduction in faxes from GP Practices to
OOH Centres
• Consent Model
• ECS – Implied to send, Explicit to view
• PCS – Explicit to send, Implied to view
Future Developments
• Integration with National A+E System
• Scottish Ambulance Service
• Preparation of Business Case
– Patient Access
– Extension of Users
– Extension of Data Set
• NO DEVELOPMENT WITHOUT
CONSULTATION
Future Developments
– Patient Access
– Extension of Users
Other hospital departments
Dentists
Community pharmacists
Future Developments
– Extension of Data Set
Immunisations
Special notes
Past medical history
Recent Consultations
Summary
• Good progress with use of ECS
• Security built in with fully integrated
solutions
• Audit at all levels with focus on inter Health
Board Access
• Palliative Care Summary next development
• Consultation and communications in
planning for next stage
Questions?
• Dr Libby Morris
([email protected])
• Jonathan Cameron
([email protected])